Provider Demographics
NPI:1245578889
Name:SHARKEY, PETER T (RDO)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:T
Last Name:SHARKEY
Suffix:
Gender:M
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1689 POST RD
Mailing Address - Street 2:EYEWEAR OUTLET
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-5938
Mailing Address - Country:US
Mailing Address - Phone:401-739-9297
Mailing Address - Fax:508-336-6201
Practice Address - Street 1:1689 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-5938
Practice Address - Country:US
Practice Address - Phone:401-739-9297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOP129156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician