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General NPI Number Information
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NPI Number | 1023426285
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Entity Type | Organization
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Legal Business Name | DR. ROCIO ALICEA O.D., LLC
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 240 INDIAN RIVER RD C-3
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City | ORANGE
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State | CT
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Zip | 06477-3649
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Country | US
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Telephone | 203-553-9797
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Fax |
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Provider Business Mailing Address
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Address Line | 240 INDIAN RIVER RD C-3
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City | ORANGE
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State | CT
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Zip | 06477-3649
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Country | US
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Telephone | 203-553-9797
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | ROCIO ALICEA
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Credential | O.D.
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Telephone | 203-553-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 002834
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License Number State | CT
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