Basic Information
| Provider Information | |||||||||
| NPI: | 1659457919 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHEFFIELD | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 PUTNAM PIKE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | SMITHFIELD | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019497300 | ||||||||
| FaxNumber: | 4019495052 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 PUTNAM PIKE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | SMITHFIELD | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019497300 | ||||||||
| FaxNumber: | 4019495052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2006 | ||||||||
| LastUpdateDate: | 12/11/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | ODTG00478 | RI | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 9007903 | 05 | RI | MEDICAID | 0469790001 | 01 | RI | NSC | OTHER |