Individual
DR. THERESA LOSCALZO BACARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1360 MONTAUK HWY, STE 2E, MASTIC, NY 11950-2929
(631) 281-2474
(631) 281-2476
Mailing address
1360 MONTAUK HWY, STE 2E, MASTIC, NY 11950-2929
(631) 281-2474
(631) 281-2476
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT004799-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198546P
HIP
NY
01
—
201972162
NVA
NY
01
—
2136929
VYTRA
NY
01
—
26993
SPECTERA
NY
01
—
34416
AVESIS
NY
01
—
6599195
GHI
NY
01
—
921377
BLOCK VISION
NY
01
—
NY0047
EYEMED
NY
01
—
P3548978
OXFORD
NY
Enumeration date
10/25/2006
Last updated
04/01/2016
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