Provider Demographics
NPI:1154375418
Name:ZERBINOPOULOS, PAUL (OD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:ZERBINOPOULOS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 VILLAGE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02879-8274
Mailing Address - Country:US
Mailing Address - Phone:401-272-2020
Mailing Address - Fax:401-789-4113
Practice Address - Street 1:55 VILLAGE SQUARE DR
Practice Address - Street 2:
Practice Address - City:SOUTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02879-8274
Practice Address - Country:US
Practice Address - Phone:401-272-2020
Practice Address - Fax:401-789-4113
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00416152W00000X
MA3465152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
720107301OtherCIGNA
004525OtherBLUE CHIP
0550437OtherAETNA HMO
410033236OtherRAILROAD MEDICARE
R001038OtherTRICARE
5921076OtherAETNA NONHMO
RI2200244OtherUNITED HEALTHCARE
RI324OtherBLUE CROSS BLUE SHIELD
RIPZ00344Medicaid
2853OtherNEIGHBORHOOD HEALTH
050369447OtherVISION SERVICE PLAN
410033236OtherRAILROAD MEDICARE
RI007000651Medicare ID - Type Unspecified