NPI 1366554420

Mark G Blasbalg, OD

Practitioner Optometrist Coventry, RI

Practice location

Address: 1193 Tiogue Ave, Coventry, RI 02816-6122
Phone: (401) 823-8200
Fax: (401) 826-8708

Registered specialties (2)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence ODTG00489 (RI)

Other Optometrist providers in Rhode Island →

Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2777 (MA)

Registry record

NPI: 1366554420
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Aug 2006
Record last updated: 9 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.