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General NPI Number Information
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NPI Number | 1881002038
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Entity Type | Organization
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Legal Business Name | TOLL GATE VISION, LTD
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 1120 TOLL GATE RD
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City | WARWICK
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State | RI
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Zip | 02886-0648
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Country | US
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Telephone | 401-821-9111
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Fax | 401-823-5852
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Provider Business Mailing Address
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Address Line | 1120 TOLL GATE RD
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City | WARWICK
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State | RI
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Zip | 02886-0648
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Country | US
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Telephone | 401-821-9111
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Fax | 401-823-5852
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD P BELHUMEUR
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Credential | OD
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Telephone | 401-822-2020
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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 |
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License Number State |
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