Basic Information
| Provider Information | |||||||||
| NPI: | 1407892888 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FICARRA | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8614 WESTWOOD CENTER DR FL 9 | ||||||||
| Address2: | |||||||||
| City: | VIENNA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221822442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038478899 | ||||||||
| FaxNumber: | 5712236780 | ||||||||
| Practice Location | |||||||||
| Address1: | 8340 COLERAIN AVE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452393916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132459099 | ||||||||
| FaxNumber: | 5132459151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1535 | KY | N | Eye and Vision Services Providers | Optometrist | 152WL0500X | 1535T | KY | N | Eye and Vision Services Providers | Optometrist | Low Vision Rehabilitation | 152W00000X | 5355 | OH | N | Eye and Vision Services Providers | Optometrist | 152W00000X | OPT.005255 | OH | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.