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Individual

DR. PETER J LIBERTO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
145 NEWPORT AVE, PAWTUCKET, RI 02861-4107
(401) 729-0200
(401) 729-0222
Mailing address
145 NEWPORT AVE, PAWTUCKET, RI 02861-4107
(401) 729-0200
(401) 729-0222

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
434T
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004369
BLUE CHIP
RI
01
22-00053
UNITEDHEALTHCARE
RI
01
2804
NEIGHBORHOOD HEALTH
RI
01
7848-3
BLUE CROSS
RI
05
9007948
RI
Enumeration date
09/15/2005
Last updated
07/08/2007
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