Provider Demographics
NPI:1932183241
Name:VACHULA, STEVEN V (OD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:V
Last Name:VACHULA
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 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:22 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2243
Practice Address - Country:US
Practice Address - Phone:413-549-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3239152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
W15678OtherBLUE SHIELD INDEMNITY
MA0353361Medicaid
042472266OtherPRIVATE HEALTHCARE SYSTEM
10267601OtherCIGNA HEALTH PLAN
35481175OtherCIGNA HEALTHSOURCE
W15678OtherBLUE CARE ELECT
042472266OtherTRICARE CHAMPUS
48391OtherFALLON COMMUNITY HEALTH
786732OtherMVP HEALTH CARE
38080OtherCHILDRENS MEDICAL SECURIT
AA2842OtherHARVARD PILGRIM HEALTHCAR
5882695OtherAETNA US HEALTHCARE
042472266OtherTHREE RIVERS
2213197OtherFIRST HEALTH
W15678OtherBLUE SHIELD HMO BLUE
2009740002OtherCIGNA PAL ID
MA0353361Medicaid
042472266OtherPRIVATE HEALTHCARE SYSTEM
VA442358Medicare ID - Type UnspecifiedB
042472266OtherTRICARE CHAMPUS