Provider Demographics
NPI:1386222370
Name:PAREDES, AMANDA G (OD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:G
Last Name:PAREDES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-2701
Mailing Address - Country:US
Mailing Address - Phone:617-361-0618
Mailing Address - Fax:
Practice Address - Street 1:385 MENDON RD
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-2477
Practice Address - Country:US
Practice Address - Phone:401-762-4473
Practice Address - Fax:401-765-3261
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA5484152W00000X
390200000X
RIODTG00716152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program