Basic Information
| Provider Information | |||||||||
| NPI: | 1912035056 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DR. AUCELLO & ASSOCIATES, P.C. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 34 SKY VIEW DR | ||||||||
| Address2: | |||||||||
| City: | AVON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060012885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606672020 | ||||||||
| FaxNumber: | 8606670770 | ||||||||
| Practice Location | |||||||||
| Address1: | 262 BROCKETT ST | ||||||||
| Address2: | |||||||||
| City: | NEWINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061113907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606672020 | ||||||||
| FaxNumber: | 8606670770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 09/05/2012 | ||||||||
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| AuthorizedOfficialLastName: | AUCELLO | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8606672020 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.