Provider Demographics
NPI:1235105131
Name:RUCCI, NAPOLEONE (OD)
Entity Type:Individual
Prefix:
First Name:NAPOLEONE
Middle Name:
Last Name:RUCCI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2907
Mailing Address - Country:US
Mailing Address - Phone:585-872-1300
Mailing Address - Fax:585-872-5397
Practice Address - Street 1:1015 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2907
Practice Address - Country:US
Practice Address - Phone:585-872-1300
Practice Address - Fax:585-872-5397
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT005237-2152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01684133Medicaid
NYU21654Medicare UPIN
NYCC3674Medicare ID - Type Unspecified