Provider Demographics
NPI:1912035056
Name:DR. AUCELLO & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:DR. AUCELLO & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUCELLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-667-2020
Mailing Address - Street 1:34 SKY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-2885
Mailing Address - Country:US
Mailing Address - Phone:860-667-2020
Mailing Address - Fax:860-667-0770
Practice Address - Street 1:262 BROCKETT ST
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-3907
Practice Address - Country:US
Practice Address - Phone:860-667-2020
Practice Address - Fax:860-667-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C02136Medicare ID - Type Unspecified