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General NPI Number Information
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NPI Number | 1497016661
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Entity Type | Organization
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Legal Business Name | SAMPALIS EYECARE PC
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 650 BALD HILL RD
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City | WARWICK
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State | RI
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Zip | 02886-1863
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Country | US
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Telephone | 401-822-2050
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Fax | 401-822-2050
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Provider Business Mailing Address
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Address Line | 24 SCARALIA RD
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City | CRANSTON
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State | RI
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Zip | 02921
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Country | US
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Telephone | 401-241-9188
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Fax | 401-828-4240
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Authorized Official
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Title or Position | DR
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Name | DR. MARIA P SAMPALIS
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Credential | O.D.
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Telephone | 401-241-9188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | MA4629
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License Number State | MA
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