Provider Demographics
NPI:1285661025
Name:CROCE, STEVEN A I
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:CROCE
Suffix:I
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:A
Other - Last Name:CROCE
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:622 GEORGE WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4211
Mailing Address - Country:US
Mailing Address - Phone:401-333-0550
Mailing Address - Fax:401-312-0083
Practice Address - Street 1:622 GEORGE WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4211
Practice Address - Country:US
Practice Address - Phone:401-333-0550
Practice Address - Fax:401-312-0083
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00DGT00473152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7000696Medicaid
RI007005044Medicare ID - Type UnspecifiedMEDICARE
RIU27637Medicare UPIN