Provider Demographics
NPI:1215393798
Name:DR VICTOR R RIGACCI, OD, PSC
Entity Type:Organization
Organization Name:DR VICTOR R RIGACCI, OD, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:RIGACCI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:859-801-1731
Mailing Address - Street 1:1594 BRANDON DR
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-9516
Mailing Address - Country:US
Mailing Address - Phone:859-801-1731
Mailing Address - Fax:
Practice Address - Street 1:4370 EASTGATE SQUARE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-4502
Practice Address - Country:US
Practice Address - Phone:513-753-8490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4996152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3039223Medicaid