Provider Demographics
NPI:1922661685
Name:COLLEGE HILL EYE AND OPTICAL INC.
Entity Type:Organization
Organization Name:COLLEGE HILL EYE AND OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLONNA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:401-331-7850
Mailing Address - Street 1:C/O 891 WESTMINSTER STREET
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903
Mailing Address - Country:US
Mailing Address - Phone:401-331-7850
Mailing Address - Fax:401-274-4739
Practice Address - Street 1:295 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-2910
Practice Address - Country:US
Practice Address - Phone:401-831-2015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty