Provider Demographics
NPI:1881017317
Name:MASSUCCI VISION PLUS LLC
Entity Type:Organization
Organization Name:MASSUCCI VISION PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MASSUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:412-760-5325
Mailing Address - Street 1:6600 BROOKTREE RD
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9205
Mailing Address - Country:US
Mailing Address - Phone:724-719-2712
Mailing Address - Fax:724-719-2713
Practice Address - Street 1:6600 BROOKTREE RD
Practice Address - Street 2:SUITE 2800
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9205
Practice Address - Country:US
Practice Address - Phone:724-719-2712
Practice Address - Fax:724-719-2713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002072152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty