Individual
WILLIAM TAMBOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DISPENSING OPTICIAN
Contact information
Practice address
919 SMITH ST, PROVIDENCE, RI 02908-2703
(401) 351-2769
Mailing address
919 SMITH ST, PROVIDENCE, RI 02908-2703
(401) 351-2769
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
1332
MA
156FX1800X
Optician
Primary
OP00075
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1332
STATE LICENSE
MA
01
—
OP00075
STATE LICENSE
RI
Enumeration date
08/31/2006
Last updated
07/08/2007
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