Basic Information
| Provider Information | |||||||||
| NPI: | 1861492001 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORMANDO | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 891 WESTMINSTER ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029034020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013317850 | ||||||||
| FaxNumber: | 4013317850 | ||||||||
| Practice Location | |||||||||
| Address1: | 891 WESTMINSTER ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029034020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013317850 | ||||||||
| FaxNumber: | 4012744750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2005 | ||||||||
| LastUpdateDate: | 09/05/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152WC0802X | ODTA-00492 | RI | N | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management | 152W00000X | ODTA-00492 | RI | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 22-00963 | 01 | UNITED HEALTH CARE | OTHER | 4128425001 | 01 | CIGNA | OTHER | 409772 | 01 | RI | BLUE CHIP | OTHER | 27970 | 01 | RI | NEIGHBORHOOD HEALTH PLAN | OTHER | 580001245 | 01 | RAILROAD/METRA HEALTH | OTHER | 814844 | 01 | MASHANTUCKET PEQUOT TRIBE | OTHER | 030510109 | 01 | VISION SERVICE PLAN | OTHER | 0000025744 | 01 | RI | BLUE SHIELD | OTHER | 3314408 | 01 | AETNA INSURANCE | OTHER | 4816730001 | 01 | HEALTHNOW NY | OTHER | 9022669 | 05 | RI | MEDICAID |