Healthcare Provider Details

I. General information

NPI: 1679569321
Provider Name (Legal Business Name): VITO R LAROCCA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

40 SAW MILL RIVER RD
HAWTHORNE NY
10532-1535
US

V. Phone/Fax

Practice location:
  • Phone: 860-837-5560
  • Fax: 860-837-6387
Mailing address:
  • Phone: 914-909-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number319696
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number224749
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number79164
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number79164
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: