Provider Demographics
NPI:1336471747
Name:DUQUETTE FAMILY EYE CARE INC
Entity Type:Organization
Organization Name:DUQUETTE FAMILY EYE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DUQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:401-769-6323
Mailing Address - Street 1:621 POUND HILL ROAD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-2006
Mailing Address - Country:US
Mailing Address - Phone:401-769-6323
Mailing Address - Fax:401-769-9202
Practice Address - Street 1:621 POUND HILL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-9358
Practice Address - Country:US
Practice Address - Phone:401-769-6323
Practice Address - Fax:401-769-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00516152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDU79122Medicaid
RIDU79122Medicaid