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General NPI Number Information
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NPI Number | 1508991688
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Entity Type | Organization
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Legal Business Name | BUCCI CATARACT AND LASER VISION INSTITUTE
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 06/23/2010
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Provider Practice Location Address
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Address Line | 158 WILKES BARRE TOWNSHIP BLVD
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City | WILKES BARRE
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State | PA
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Zip | 18702-6704
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Country | US
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Telephone | 570-825-5949
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Fax | 570-825-2645
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Provider Business Mailing Address
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Address Line | 158 WILKES BARRE TOWNSHIP BLVD
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City | WILKES BARRE
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State | PA
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Zip | 18702-6704
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Country | US
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Telephone | 570-825-5949
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Fax | 570-825-2645
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. FRANK A BUCCI SR.
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Credential | MD
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Telephone | 570-825-5949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD046074L
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License Number State | PA
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