Provider Demographics
NPI:1609835685
Name:PASCUCCI, RICHARD PETER (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PETER
Last Name:PASCUCCI
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 1:2318 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5810
Mailing Address - Country:US
Mailing Address - Phone:315-732-7121
Mailing Address - Fax:
Practice Address - Street 1:2318 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5810
Practice Address - Country:US
Practice Address - Phone:315-732-7121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0058511152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U66709Medicare UPIN
NYBB8320Medicare ID - Type Unspecified