Provider Demographics
NPI:1750678884
Name:RAY, REBECCA M (OD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:RAY
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:375 ALLENS AVE STE 2020
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-5010
Mailing Address - Country:US
Mailing Address - Phone:401-780-2511
Mailing Address - Fax:401-780-2565
Practice Address - Street 1:335R PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2426
Practice Address - Country:US
Practice Address - Phone:401-444-0422
Practice Address - Fax:401-444-0427
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI00569152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist