Provider Demographics
NPI:1871725408
Name:FEZZUOGLIO, FRANCESCO JR (RDO)
Entity type:Individual
Prefix:MR
First Name:FRANCESCO
Middle Name:
Last Name:FEZZUOGLIO
Suffix:JR
Gender:M
Credentials:RDO
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:49 S COUNTY COMMONS WAY
Mailing Address - Street 2:UNIT F4
Mailing Address - City:SOUTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02879-8200
Mailing Address - Country:US
Mailing Address - Phone:401-782-1310
Mailing Address - Fax:401-782-1376
Practice Address - Street 1:49 S COUNTY COMMONS WAY
Practice Address - Street 2:UNIT F4
Practice Address - City:SOUTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02879-8200
Practice Address - Country:US
Practice Address - Phone:401-782-1310
Practice Address - Fax:401-782-1376
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-15
Last Update Date:2009-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIOP00302156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician