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General NPI Number Information
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NPI Number | 1922195890
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Entity Type | Organization
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Legal Business Name | CUMBERLAND FAMILY EYE CARE, LTD.
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 250 WAMPANOAG TRAIL SUITE 304
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City | EAST PROVIDENCE
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State | RI
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Zip | 02915-2217
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Country | US
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Telephone | 401-435-5555
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Fax | 401-431-5906
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Provider Business Mailing Address
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Address Line | 250 WAMPANOAG TRL SUITE 304
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City | RIVERSIDE
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State | RI
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Zip | 02915-2218
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Country | US
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Telephone | 401-435-5555
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Fax | 401-431-5906
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Authorized Official
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Title or Position | TREASURER
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Name | DR. STEVEN W. SANTOS
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Credential | O.D.
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Telephone | 401-435-5555
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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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