Watanabe, Ronald Kiyoshi
Watanabe, Ronald Kiyoshi is an individual health care provider with primary practice located at 15 Central St , Andover MA 01810-3718. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Watanabe, Ronald Kiyoshi can be contacted via phone (978) 475-5252.Contact Information
Primary practice address
15 Central St
Andover MA 01810-3718
Phone: (978) 475-5252
Fax: (978) 475-2226
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3763 | Massachusetts |
Profile Details
| NPI number | 1942200316 |
|---|---|
| LBN Legal business name | Watanabe, Ronald Kiyoshi |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Aug 23rd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942200316 | NPPES |
| Massachusetts | Other | 1552937 | COVENTRY |
| Massachusetts | Other | 402787 | COVENTRY |
| Massachusetts | Other | W16025 | COVENTRY |
| Massachusetts | Other | 610461 | COVENTRY |
| Massachusetts | Other | 54742 | COVENTRY |
| Massachusetts | Other | 153220 | COVENTRY |
| Massachusetts | MEDICAID | 317390 | COVENTRY |
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