MEDICARE: GRETA PUCCI OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	RT009894-01	NY

General Provider Information

NPI Number	:	1184301657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRETA PUCCI OD

Provider Business Mailing Address
First Line	:	815 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-4171
Country	:	US
Telephone Number	:	845-596-2189
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-4171
Country	:	US
Telephone Number	:	917-891-8800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2023
Last Update Date	:	05/16/2025

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