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General NPI Number Information
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NPI Number | 1487911855
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Entity Type | Organization
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Legal Business Name | HANOVER FAMILY EYECARE
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 7074 MECHANICSVILLE TPKE
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-3629
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Country | US
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Telephone | 804-746-5245
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Fax | 804-559-7855
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Provider Business Mailing Address
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Address Line | 7074 MECHANICSVILLE TURNPIKE
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-4705
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Country | US
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Telephone | 804-746-5245
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Fax | 804-559-7855
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. RAJANISH SETTY
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Credential | O.D.
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Telephone | 804-746-5245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618001934
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License Number State | VA
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