Individual
MICHAEL J HORAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LICENSED OPTICIAN
Contact information
Practice address
73 VALLEY RD, MIDDLETOWN, RI 02842-5234
(401) 841-0966
(401) 841-0161
Mailing address
73 VALLEY RD, MIDDLETOWN, RI 02842-5234
(401) 841-0966
(401) 841-0161
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
189
RI
156FX1800X
Optician
4475
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21-02007
UNITED HEALTHCARE
RI
01
—
22393-9
BCBSRI,HMATE,HMATE2000
RI
01
—
2440
NHP OF RHODE ISLAND
RI
05
—
2490001
—
RI
01
—
408112
BLUE CHIP,MCHIP,HMOBLUE
RI
Enumeration date
05/11/2006
Last updated
07/08/2007
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