Individual
ELINA GOMAN BASKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
50 MAUDE ST, PROVIDENCE, RI 02908-4325
(401) 351-5664
(401) 456-5726
Mailing address
50 CASTLE DR, SHARON, MA 02067-2442
(781) 818-4118
(781) 818-4118
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODTA00493
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31251-6
BLUE SHIELD
RI
01
—
412591
BLUECHIP
RI
05
—
EG59603
—
RI
Enumeration date
05/10/2006
Last updated
07/21/2011
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