MEDICARE: DOCTOR ANTHONY GIOSCIA OPTOMETRIST LLC

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	2418	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	918245	OTHER	CT	BLOCK VISION
2	090002418CT-04	OTHER	CT	ANTHEM BLUE CROSS - BLOOM
3	090002418CT-03	OTHER	CT	ANTHEM BLUE CROSS MANCH
4	102418	OTHER	CT	CONNECTICUT CARE
5	17448	OTHER	CT	AVESIS
6	918043	OTHER	CT	EYEMED
7	50673	OTHER	CT	DAVIS VISION
8	09440	OTHER	CT	SPECTERA

General Provider Information

NPI Number	:	1528141983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTOR ANTHONY GIOSCIA OPTOMETRIST LLC

Provider Business Mailing Address
First Line	:	397 COTTAGE GROVE RD
Second Line	:
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3119
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	397 COTTAGE GROVE RD
Second Line	:
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3119
Country	:	US
Telephone Number	:	860-243-8003
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANTHONY GIOSCIA
Credential	:	O.D.
Telephone Number	:	860-763-4895

Provider Enumeration Date	:	10/21/2006
Last Update Date	:	08/22/2020

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