Organization
CRANSTON EYE ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT SURDUT (OD)
14019424087
Entity
Organization
Contact information
Practice address
1013 RESERVOIR AVE, CRANSTON, RI 02910-5134
(401) 942-4087
(401) 942-3342
Mailing address
1013 RESERVOIR AVE, CRANSTON, RI 02910-5134
(401) 942-4087
(401) 942-3342
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODTA 00356
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
092470
MEDICARE P-TAN
RI
05
—
7002604
—
RI
Enumeration date
12/18/2006
Last updated
10/19/2010
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