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General NPI Number Information
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NPI Number | 1124448261
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Entity Type | Organization
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Legal Business Name | RICHARD P PASCUCCI
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 2318 GENESEE ST
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City | UTICA
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State | NY
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Zip | 13502-5810
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Country | US
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Telephone | 315-732-7121
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 252
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City | CLINTON
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State | NY
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Zip | 13323-0252
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | CARLA PASCUCCI
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Credential |
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Telephone | 315-368-8098
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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 | TUV005851
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License Number State | NY
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