Provider Demographics
NPI:1043438856
Name:CHERYL A. LANDRY, O.D., J.D., P.C.
Entity Type:Organization
Organization Name:CHERYL A. LANDRY, O.D., J.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:OD, JD
Authorized Official - Phone:401-762-2011
Mailing Address - Street 1:191 SOCIAL ST
Mailing Address - Street 2:SUITE 640
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3240
Mailing Address - Country:US
Mailing Address - Phone:401-762-2011
Mailing Address - Fax:401-762-2012
Practice Address - Street 1:191 SOCIAL ST
Practice Address - Street 2:SUITE 640
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3240
Practice Address - Country:US
Practice Address - Phone:401-762-2011
Practice Address - Fax:401-762-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00508332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier