Provider Demographics
NPI:1588819361
Name:LAMBERT, MEGHAN M (OD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:M
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-3826
Mailing Address - Country:US
Mailing Address - Phone:510-468-9155
Mailing Address - Fax:
Practice Address - Street 1:400 WARREN AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-3826
Practice Address - Country:US
Practice Address - Phone:510-468-9155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2111152W00000X
RI556152W00000X
MA4844152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist