Healthcare Provider Details

I. General information

NPI: 1639380041
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: 09/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 EVERGREEN WAY
SOUTH WINDSOR CT
06074-6975
US

IV. Provider business mailing address

34 SKY VIEW DR
AVON CT
06001-2885
US

V. Phone/Fax

Practice location:
  • Phone: 860-644-4362
  • Fax: 860-667-0770
Mailing address:
  • Phone: 860-667-2020
  • Fax: 860-667-0770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberCT2192
License Number State

VIII. Authorized Official

Name: DR. PATRICIA AUCELLO
Title or Position: OWNER
Credential: OD
Phone: 860-667-2020