Healthcare Provider Details

I. General information

NPI: 1124826433
Provider Name (Legal Business Name): HANNAH ROSE MOYZES OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 S MAIN ST
WEST HARTFORD CT
06107-2407
US

IV. Provider business mailing address

136 ARLINGTON ST APT 2
BRIGHTON MA
02135-2133
US

V. Phone/Fax

Practice location:
  • Phone: 860-231-8482
  • Fax:
Mailing address:
  • Phone: 602-459-3177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3398
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: