Provider Demographics
NPI:1013902816
Name:ANDREONI, WILLIAM J (OPHTHALMOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:ANDREONI
Suffix:
Gender:M
Credentials:OPHTHALMOLOGIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1524 ATWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-272-2110
Mailing Address - Fax:401-272-0388
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-272-2110
Practice Address - Fax:401-273-6236
Is Sole Proprietor?:No
Enumeration Date:2005-09-18
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD05964207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9002209Medicaid
RI9002209Medicaid
RI007004385Medicare PIN