Provider Demographics
NPI:1417025503
Name:PIRONE, TRICIA LYNN (OD)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:LYNN
Last Name:PIRONE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 BRIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2322
Mailing Address - Country:US
Mailing Address - Phone:207-210-6700
Mailing Address - Fax:207-899-3239
Practice Address - Street 1:595 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2322
Practice Address - Country:US
Practice Address - Phone:207-210-6700
Practice Address - Fax:207-899-3239
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME24666152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEAA65757OtherHARVARD PILGRIM
ME109280499Medicaid
ME100521OtherANTHEM
MEME1826Medicare PIN
V08315Medicare UPIN