Provider Demographics
NPI:1952529463
Name:ANDERSON, CINDA L (OD)
Entity type:Individual
Prefix:DR
First Name:CINDA
Middle Name:L
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 KENT ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3800
Mailing Address - Country:US
Mailing Address - Phone:401-247-7393
Mailing Address - Fax:508-336-1820
Practice Address - Street 1:33 KENT ST
Practice Address - Street 2:SUITE C
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3800
Practice Address - Country:US
Practice Address - Phone:401-247-7393
Practice Address - Fax:508-336-1820
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA4058152W00000X
RIODTA00499152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW17471Medicare ID - Type Unspecified