Provider Demographics
NPI:1609938240
Name:DRS FOGARTY & PLIAKAS LTD
Entity Type:Organization
Organization Name:DRS FOGARTY & PLIAKAS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PLIAKAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:401-949-1430
Mailing Address - Street 1:634 PUTNAM PIKE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-1419
Mailing Address - Country:US
Mailing Address - Phone:401-949-1430
Mailing Address - Fax:401-949-1431
Practice Address - Street 1:634 PUTNAM PIKE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-1419
Practice Address - Country:US
Practice Address - Phone:401-949-1430
Practice Address - Fax:401-949-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTA00296152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0210500001OtherMEDICARE NSC
RI0210500001Medicare NSC