Provider Demographics
NPI:1376579821
Name:CROCE AND PUGLIESE VISION CARE
Entity Type:Organization
Organization Name:CROCE AND PUGLIESE VISION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:PUGLIESE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:401-333-0550
Mailing Address - Street 1:622 GEORGE WASHINGTON HWY
Mailing Address - Street 2:LINCOLN MALL
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:LINCOLN MALL
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00474152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty