Active NPI
Robert Hazen, OPTICIAN
- Optician
- Wilmington, DE
National Provider Identifier
1104998723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1991073141
- Practice address
- 4750 Limestone Rd
Wilmington, DE 19808-1928 - Phone
- (302) 998-0551
- Fax
- (302) 998-0877
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1991073141 | DE | Primary |
Addresses
Primary practice location
4750 Limestone Rd
Wilmington, DE 19808-1928
Mailing address
4750 Limestone Rd
Wilmington, DE 19808-1928
Phone (302) 998-0551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1991073141 | DE | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1104998723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 LIMESTONE RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198081928",
"telephone_number": "302-998-0551",
"fax_number": "302-998-0877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4750 LIMESTONE RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198081928",
"telephone_number": "302-998-0551",
"fax_number": "302-998-0877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZEN",
"first_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "DE",
"license": "1991073141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
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- Taylor Hayslip
- Trina Brooks Haywood, CNM
- Sonya L Hazelett, BA
- Michael Hazuda Jr., D.M.D.
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- Healing the Inner You,L.L.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.