Provider Demographics
NPI:1417995101
Name:LONARDO OPTICIANS
Entity Type:Organization
Organization Name:LONARDO OPTICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:FOLGO
Authorized Official - Suffix:
Authorized Official - Credentials:RO
Authorized Official - Phone:401-353-2010
Mailing Address - Street 1:1543 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:N PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-2943
Mailing Address - Country:US
Mailing Address - Phone:401-353-2010
Mailing Address - Fax:401-353-0380
Practice Address - Street 1:1543 SMITH ST
Practice Address - Street 2:
Practice Address - City:N PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2943
Practice Address - Country:US
Practice Address - Phone:401-353-2010
Practice Address - Fax:401-353-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOP00271332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI2100005OtherUNITED HEALTH CARE
RI9923-7OtherBLUE CROSS
RI201592OtherBLUE CHIP
RI9009923Medicaid
RI0166190001Medicare NSC