MEDICARE: MRS. RACHEL KAHAN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	VUT005842-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	40934	OTHER	NY	DAVISVISION
2	0120026701	OTHER	NY	AMERICHOICE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	215800101	OTHER	NY	HEALTHPLUS
5	VUT005842	OTHER	NY	HIP HEALTH PLAN
6	P128136	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1043279573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL KAHAN O.D.

Provider Business Mailing Address
First Line	:	934 E 18TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3102
Country	:	US
Telephone Number	:	718-758-1903
Fax Number	:	718-758-1903

Provider Business Practice Location Address
First Line	:	934 E 18TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3102
Country	:	US
Telephone Number	:	718-758-1903
Fax Number	:	718-758-1903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	02/09/2010

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