Healthcare Provider Details

I. General information

NPI: 1043484264
Provider Name (Legal Business Name): RACHA DERMESROPIAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHA ABBOUD

II. Dates (important events)

Enumeration Date: 04/18/2008
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST STE 725
HARTFORD CT
06106-5501
US

IV. Provider business mailing address

80 SEYMOUR ST
HARTFORD CT
06102-8000
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-3526
  • Fax:
Mailing address:
  • Phone: 860-972-2085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number051406
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: