Provider Demographics
NPI:1679569321
Name:LAROCCA, VITO R (MD)
Entity Type:Individual
Prefix:DR
First Name:VITO
Middle Name:R
Last Name:LAROCCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1535
Mailing Address - Country:US
Mailing Address - Phone:914-909-4700
Mailing Address - Fax:
Practice Address - Street 1:40 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1535
Practice Address - Country:US
Practice Address - Phone:914-909-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224749207W00000X, 207WX0110X
NY319696207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA462285OtherTUFTS HEALTH PLAN
MAA39088OtherMEDICARE
AA184736OtherHARVARD PILGRIM
MA110041636AMedicaid
MA110041636AMedicaid