Warren Eye Clinic Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

35-05-7104-M Issued in OH

Legal business name

WARREN EYE CLINIC INC

Practice address

302 Niles Cortland Rd NE
Warren, OH 44484-1940

Phone

(330) 395-2020

Fax

(330) 395-6200

NPI assigned

Oct 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. James V Martuccio Jr., M.D.

Title

Owner/Employee

Phone

(330) 395-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1942499512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841940",
            "telephone_number": "330-395-2020",
            "fax_number": "330-395-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841940",
            "telephone_number": "330-395-2020",
            "fax_number": "330-395-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN EYE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "MARTUCCIO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER/EMPLOYEE",
        "authorized_official_telephone_number": "330-395-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35-05-7104-M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0242393",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Warren, OH
• Providers in Warren, OH by specialty
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.