Dr Anthony W Iraca of Medford Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

3432 Issued in MA

Legal business name

DR ANTHONY W IRACA OF MEDFORD INC

Practice address

4110 Mystic Valley Parkway
Medford, MA 02155

Phone

(781) 391-1195

Fax

(781) 395-7875

NPI assigned

Oct 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony Walter Iraca Jr., OD

Title

President

Phone

(781) 391-1195

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1396933826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 MYSTIC VALLEY PARKWAY",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "781-391-1195",
            "fax_number": "781-395-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 MYSTIC VALLEY PARKWAY",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "781-391-1195",
            "fax_number": "781-395-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ANTHONY W IRACA OF MEDFORD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "IRACA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-391-1195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3432",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MA",
            "license": "3432",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W20411",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Dorsey, CCC-SLP
• Helder Dos Santos Oliveira, BA
• Diane M Doucette, FNP
• Mark James Doughtie, ATC
• Meghan Colleen Dowd Murray, LICSW
• Dr. Farzad T Parsi DDS PC
• Dr. Richard a Short DMD, Dr. Ronni Ann Schnell DMD
• Dr. Young Park Dental Group - Medford, PLLC
• Dr.Eric Gheewalla
• Morgan Drew

• Optometrist in Medford, MA
• Providers in Medford, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.