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General NPI Number Information
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NPI Number | 1891822797
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Entity Type | Organization
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Legal Business Name | WATERMAN EYE CARE, INC.
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 426 SCRABBLETOWN RD SUITE A
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-3649
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Country | US
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Telephone | 401-295-7339
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Fax | 401-295-7311
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Provider Business Mailing Address
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Address Line | 426 SCRABBLETOWN RD SUITE A
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-3649
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Country | US
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Telephone | 401-295-7339
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Fax | 401-295-7311
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELLIOT D. WATERMAN
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Credential | O.D.
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Telephone | 401-295-7339
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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 | ODTG-397
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License Number State | RI
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