Provider Demographics
NPI:1679670798
Name:PIRAINO, VINCENT A (OD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:A
Last Name:PIRAINO
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 1:9393 N 90TH ST
Mailing Address - Street 2:SUITE 102-173
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1040 S GILBERT RD
Practice Address - Street 2:#101
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3469
Practice Address - Country:US
Practice Address - Phone:480-893-8776
Practice Address - Fax:480-753-6314
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ872152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU49759Medicare UPIN