Provider Demographics
NPI:1518922889
Name:FERRIS, DAVID W (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:FERRIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3855
Mailing Address - Country:US
Mailing Address - Phone:401-732-2350
Mailing Address - Fax:401-738-2744
Practice Address - Street 1:222 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3855
Practice Address - Country:US
Practice Address - Phone:401-732-2350
Practice Address - Fax:401-738-2744
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00314152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI795299OtherTUFTS
RI97774OtherBLUE CROSS BLUE SHIELD
RI544596OtherAETNA
RI003113OtherBLUE CHIP
RI1775280OtherCIGNA
RI2200166OtherUNITED HEALTHCARE
RI9009876Medicaid
RI795299OtherTUFTS
RI544596OtherAETNA