Organization
GLENN S. PRESCOD, M.D., M.P.H., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN S. PRESCOD M.D. (OWNER)
(401) 725-3600
Entity
Organization
Contact information
Practice address
333 SCHOOL ST, SUITE 301, PAWTUCKET, RI 02860-5334
(401) 725-3600
(401) 728-8760
Mailing address
333 SCHOOL ST, SUITE 301, PAWTUCKET, RI 02860-5334
(401) 725-3600
(401) 728-8760
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
08767
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9020656
—
RI
Enumeration date
10/30/2012
Last updated
12/12/2012
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