MEDICARE: DR. ANTHONY P FICARRA 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	1535	KY
2	152WL0500X	Low Vision Rehabilitation Optometrist	1535T	KY
3	152W00000X	Optometrist	5355	OH
4	152W00000X	Optometrist	OPT.005255	OH

General Provider Information

NPI Number	:	1407892888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY P FICARRA OD

Provider Business Mailing Address
First Line	:	8614 WESTWOOD CENTER DR FL 9
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-2442
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:	571-223-6780

Provider Business Practice Location Address
First Line	:	8340 COLERAIN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-3916
Country	:	US
Telephone Number	:	513-245-9099
Fax Number	:	513-245-9151

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	08/09/2022

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