Provider Demographics
NPI:1245241256
Name:VELOCCI, LOUIS (OD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:VELOCCI
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 1:20 FINN RD STE C
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9388
Mailing Address - Country:US
Mailing Address - Phone:585-321-5581
Mailing Address - Fax:
Practice Address - Street 1:20 FINN RD STE C
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9388
Practice Address - Country:US
Practice Address - Phone:585-321-5581
Practice Address - Fax:585-321-0321
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004723-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP017846659OtherEXCELLUS
NYP020004723OtherBC/BS
NYP010004723OtherBLUE CHOICE
NY101971CSOtherPREFERRED CARE
NYP020004723OtherBC/BS
NYT26144Medicare UPIN