Provider Demographics
NPI:1952423915
Name:JAMES A LUCCIO AND ASSOCIATES INC
Entity Type:Organization
Organization Name:JAMES A LUCCIO AND ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:LUCCIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-587-2500
Mailing Address - Street 1:516 WESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1816
Mailing Address - Country:US
Mailing Address - Phone:508-587-2500
Mailing Address - Fax:508-587-2530
Practice Address - Street 1:516 WESTGATE DR
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1816
Practice Address - Country:US
Practice Address - Phone:508-578-2500
Practice Address - Fax:508-587-2530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA2671152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA99406902OtherNETWORK HEALTH
MA9777423Medicaid
MAMA2671OtherEYEMED
MA9777423Medicaid