Provider Demographics
NPI:1013088137
Name:FERRUCCI, RONALD RICHARD (OD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:RICHARD
Last Name:FERRUCCI
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 1:192 WEST ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2239
Mailing Address - Country:US
Mailing Address - Phone:508-473-0395
Mailing Address - Fax:508-478-3392
Practice Address - Street 1:192 WEST ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2239
Practice Address - Country:US
Practice Address - Phone:508-473-0395
Practice Address - Fax:508-478-3392
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2468152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0332402Medicaid
MA11222745OtherCAQH
MA0332402Medicaid