Provider Demographics
NPI:1245966530
Name:THE NOVEL EYE LLC
Entity type:Organization
Organization Name:THE NOVEL EYE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED OPTICIAN/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:REBELLO
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:401-251-2309
Mailing Address - Street 1:1 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5111
Mailing Address - Country:US
Mailing Address - Phone:401-251-2309
Mailing Address - Fax:401-223-5846
Practice Address - Street 1:1 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-5111
Practice Address - Country:US
Practice Address - Phone:401-251-2309
Practice Address - Fax:401-223-5846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier