Provider Demographics
NPI:1851315824
Name:VERRUTO, ERIC ROMEO (OD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ROMEO
Last Name:VERRUTO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 WESTAGE BUSINESS CTR DR
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2264
Mailing Address - Country:US
Mailing Address - Phone:845-896-9280
Mailing Address - Fax:845-896-0246
Practice Address - Street 1:200 WESTAGE BUSINESS CTR DR
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2264
Practice Address - Country:US
Practice Address - Phone:845-896-9280
Practice Address - Fax:845-896-0246
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007031152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist