Provider Demographics
NPI:1154611283
Name:LUCCHETTI TOTAL VISION PLLC
Entity type:Organization
Organization Name:LUCCHETTI TOTAL VISION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:D
Authorized Official - Last Name:LUCCHETTI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-996-5640
Mailing Address - Street 1:228 BUFFALO PLAZA
Mailing Address - Street 2:
Mailing Address - City:SARVER
Mailing Address - State:PA
Mailing Address - Zip Code:16055-8302
Mailing Address - Country:US
Mailing Address - Phone:724-996-5640
Mailing Address - Fax:
Practice Address - Street 1:228 BUFFALO PLAZA
Practice Address - Street 2:
Practice Address - City:SARVER
Practice Address - State:PA
Practice Address - Zip Code:16055-8302
Practice Address - Country:US
Practice Address - Phone:724-996-5640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
152W00000X
PAOEG001016335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty