Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | ODTA00489 | RI |
NPI | 1003935727 |
---|---|
Provider Name | Jason A Soscia |
First Address | Cranston, RI 02920-4046 |
Second Address | North Providence, RI 02904-3742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |