Provider Demographics
NPI:1700871449
Name:CORVESE, ARTHUR J (OPTOMETRIST)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:J
Last Name:CORVESE
Suffix:
Gender:M
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 ATWOOD AVE 240
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:401-351-6100
Mailing Address - Fax:401-369-7255
Practice Address - Street 1:1524 ATWOOD AVE 240
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:401-351-6100
Practice Address - Fax:401-369-7255
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00472152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIAC00417Medicaid
RI1147830001Medicare NSC
RIAC00417Medicaid
RI419002425Medicare PIN