Provider Demographics
NPI:1538275433
Name:MESSINA, CLAIRE (OD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:
Last Name:MESSINA
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 1:50 MAUDE STREET
Mailing Address - Street 2:PROVIDENCE EYE ASSOCIATES
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-4325
Mailing Address - Country:US
Mailing Address - Phone:401-351-5664
Mailing Address - Fax:401-456-5726
Practice Address - Street 1:50 MAUDE ST
Practice Address - Street 2:PROVIDENCE EYE ASSOCIATES
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4325
Practice Address - Country:US
Practice Address - Phone:401-351-5664
Practice Address - Fax:401-456-5726
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG470152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICM35074Medicaid
RIT53493Medicare UPIN