MARK DERESIENSKI (NPI# 1952494759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952494759 |
| Entity Type | Individual |
| Full Name | MARK DERESIENSKI |
| Credential | O.D. |
| Practice Address |
20 Hampton Way Bldg#1a Wakefield RI 02879-2553 |
| Mailing Address |
175 Paramount Dr Suite 203 Raynham MA 02767-1065 |
| Practice Telephone | 4017837009 |
| Practice Fax Number | 4017893909 |
| Mailing Telephone | 7743203040 |
| Mailing Fax Number | 5089102204 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2017-05-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | ODTG00475 | RI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 7006708 | 05 |
| Street Address |
20 HAMPTON WAY BLDG#1A |
| City | WAKEFIELD |
| State | RI |
| Zip Code | 02879-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619060480 | Barry M Wepman | Ophthalmology | 20 Hampton Way, Bldg #1a, Wakefield, RI 02879-2553 | 2006-10-02 |
| 1093266512 | Koch Eye Associates LLP | Optometrist | 20 Hampton Way, Bldg 1a, Wakefield, RI 02879-2553 | 2016-10-19 |
| 1609271642 | Koch Eye Associates, LLP | Optometrist | 20 Hampton Way, Building #1a, Wakefield, RI 02879-2553 | 2014-11-04 |
| 1952742934 | Kristen Lee Burns | Optometrist | 20 Hampton Way, Bldg# 1a, Wakefield, RI 02879-2553 | 2013-07-08 |
| 1316030125 | Nicole Fantoni | Optometrist | 20 Hampton Way, Bldg#1a, Wakefield, RI 02879-2553 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831549435 | Bh Brightview Commons Opco, LLC | Alzheimer Center (Dementia Center) | 57 Grandeville Court, Wakefield, RI 02879 | 2016-06-15 |
| 1215392071 | Leslie Healy | Occupational Therapist | 12 Galleon Ct, Wakefield, RI 02879 | 2015-12-22 |
| 1649673799 | Peter Storti | Clinic/Center | 28 Columbia Street, Wakefield, RI 02879 | 2014-10-03 |
| 1285988790 | Silver Spring Health Care Management, Inc. | Physician Assistant | 70 Kenyon Ave Unit 321, Wakefield, RI 02879 | 2012-11-06 |
| 1013271584 | Amy Lee Barker | Speech-Language Pathologist | 213 Robinson Street, Wakefield, RI 02879 | 2012-06-29 |
| 1366708489 | Paige Houlihan | Student in an Organized Health Care Education/Training Program | 91 Rocky Brook Way St, Wakefield, RI 02879 | 2012-04-03 |
| 1639307176 | Perspectives Corporation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 53 Dockray Street, Wakefield, RI 02879 | 2009-06-23 |
| 1649482233 | Marilyn A. Cooney | Speech-Language Pathologist | 307 Curtis Corner Road, Wakefield, RI 02879 | 2007-05-04 |
| 1518184522 | Keeley Therese Dante-card | Registered Nurse | 55 Cherry Lane, Wakefield, RI 02879 | 2007-04-19 |
| 1679799217 | Codac Inc | Peer Specialist | 350 Columbia St, Codac South County, Wakefield, RI 02879 | 2007-04-18 |
| Find all providers in zip 02879 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326072810 | Raffaele A Petrosino | Optometrist | 22 Yale Ave, Wakefield, MA 01880-2309 | 2006-07-10 |
| 1023067337 | Optometric Care Inc | Optometrist | 553 Kingstown Road, Wakefield, RI 02879 | 2006-05-06 |
| 1760451116 | Alan D. Beaulieu | Optometrist | 336 Main St, Wakefield Eye Associates, Wakefield, MA 01880-5013 | 2006-03-17 |
| 1518954940 | Steven M. Kreiger | Optometrist | 133 Main St, Wakefield, RI 02879-3511 | 2005-09-30 |
| 1093266512 | Koch Eye Associates LLP | Optometrist | 20 Hampton Way, Bldg 1a, Wakefield, RI 02879-2553 | 2016-10-19 |
| 1609271642 | Koch Eye Associates, LLP | Optometrist | 20 Hampton Way, Building #1a, Wakefield, RI 02879-2553 | 2014-11-04 |
| 1073949061 | Andrea Farber | Optometrist | 669 Main St, Wakefield, MA 01880-5221 | 2013-09-23 |
| 1952742934 | Kristen Lee Burns | Optometrist | 20 Hampton Way, Bldg# 1a, Wakefield, RI 02879-2553 | 2013-07-08 |
| 1982965943 | Fei Siu | Optometrist | 669 Main St, Wakefield, MA 01880-5221 | 2012-06-06 |
| 1316247273 | Dr Steven Michael Kreiger & Associates, Inc. | Optometrist | 133 Main St, Wakefield, RI 02879-3511 | 2010-10-26 |
| Find all providers in WAKEFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.