Healthcare Provider Details

I. General information

NPI: 1881805208
Provider Name (Legal Business Name): DR.AUCELLO & ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 LEWIS AVE STE 39
MERIDEN CT
06451-2103
US

IV. Provider business mailing address

470 LEWIS AVE STE 39
MERIDEN CT
06451-2103
US

V. Phone/Fax

Practice location:
  • Phone: 203-237-4280
  • Fax:
Mailing address:
  • Phone: 203-237-4280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2192
License Number StateCT

VIII. Authorized Official

Name: DR. PATRICIA AUCELLO
Title or Position: OWNER
Credential: OD
Phone: 860-594-4585