Provider Demographics
NPI:1295856540
Name:GARDEN CITY EYECARE, INC
Entity Type:Organization
Organization Name:GARDEN CITY EYECARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DICHIARA PASTORE
Authorized Official - Suffix:
Authorized Official - Credentials:OD FAAO
Authorized Official - Phone:401-943-8151
Mailing Address - Street 1:1150 RESERVOIR AVE
Mailing Address - Street 2:LL 5
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6068
Mailing Address - Country:US
Mailing Address - Phone:401-943-8151
Mailing Address - Fax:
Practice Address - Street 1:1150 RESERVOIR AVE
Practice Address - Street 2:LL 5
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6068
Practice Address - Country:US
Practice Address - Phone:401-943-8151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGC00269Medicaid
RI419002602Medicare PIN
RI0399810001Medicare NSC