DR. CARMINE JOHN PETRACCA (NPI# 1457468613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457468613 |
| Entity Type | Individual |
| Full Name | DR. CARMINE JOHN PETRACCA |
| Credential | OD |
| Practice Address |
939 Bryden Lewiston ID 83501-5097 |
| Practice Telephone | 2087431761 |
| Practice Fax Number | 2087468042 |
| Mailing Telephone | 2087431761 |
| Mailing Fax Number | 2087468042 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | ODP634 | ID | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396757209 | Carmine Brian Petracca | Obstetrics & Gynecology | 1021 Park Ave, New York, NY 10028-0959 | 2006-08-12 |
| Street Address |
939 BRYDEN |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-5097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710276324 | Wilson Polito Pllc | Optometrist | 739 Bryden Ave Ste A, Lewiston, ID 83501-4909 | 2011-04-04 |
| 1396995239 | Isaac M Bell | Optometrist | 210 Thain Rd, Lewiston, ID 83501-4830 | 2008-09-29 |
| 1568560811 | Lee U De Rosa | Optometrist | 633 Main St, Lewiston, ME 04240-5938 | 2006-09-20 |
| 1285745075 | Arthur Gene Osterberg | Optometrist | 1313 G St, Lewiston, ID 83501-1934 | 2006-08-31 |
| 1972610236 | Donald K James | Optometrist | 3330 4th St, Lewiston, ID 83501-4405 | 2006-08-24 |
| 1821013913 | Edward Bruce Kirn | Optometrist | 249 Main Street, Lewiston, ME 04240-7053 | 2006-07-12 |
| 1801821616 | Melissa M Bell | Optometrist | 1910 Idaho St, Lewiston, ID 83501-2564 | 2006-07-11 |
| 1821024050 | John T Rietz | Optometrist | 1616 19th Ave, Lewiston, ID 83501-4005 | 2006-06-22 |
| 1962458505 | Reginald Mailhot | Optometrist | 220 Sabattus St, Lewiston, ME 04240-6347 | 2006-05-25 |
| 1396701199 | William Peter Galano | Optometrist | 608 Bryden Ave, Lewiston, ID 83501-5115 | 2006-04-21 |
| Find all providers in LEWISTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.