Individual
DR. THOMAS A ANTONIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2728 PAWT AVE, EAST PROV, RI 02914
(401) 434-5532
(401) 435-3405
Mailing address
2728 PAWTUCKET AVE, EAST PROVIDENCE, RI 02914
(401) 434-5532
(401) 435-3405
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2550
MA
152W00000X
Optometrist
Primary
ODTG00480
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9009886
—
RI
Enumeration date
09/01/2006
Last updated
08/01/2012
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