Provider Demographics
NPI:1437456449
Name:CIOCCA, ANGELA ROSE (OD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:ROSE
Last Name:CIOCCA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:64 SCENIC RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-5196
Mailing Address - Country:US
Mailing Address - Phone:413-537-2068
Mailing Address - Fax:
Practice Address - Street 1:185 HIGH ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6504
Practice Address - Country:US
Practice Address - Phone:413-536-7670
Practice Address - Fax:413-536-7671
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3710152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist