Provider Demographics
NPI:1528084662
Name:HAWRAN, RACHEL LYN (OD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:LYN
Last Name:HAWRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:LYN
Other - Last Name:HAWRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:96 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4069
Mailing Address - Country:US
Mailing Address - Phone:203-438-5855
Mailing Address - Fax:203-431-0318
Practice Address - Street 1:96 DANBURY RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4069
Practice Address - Country:US
Practice Address - Phone:203-438-5855
Practice Address - Fax:203-431-0318
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOP2000564152W00000X
FLOPC6418152W00000X
OHOPT.007242152W00000X
CT002695152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTV10276Medicare UPIN
CTC02686Medicare PIN