Basic Information
| Provider Information | |||||||||
| NPI: | 1023305760 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORALES | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | ALEYDA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | RYCHWALSKI | ||||||||
| OtherFirstName: | ANA | ||||||||
| OtherMiddleName: | ALEYDA | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 263 FARMINGTON AVENUE | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060308051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606793540 | ||||||||
| FaxNumber: | 8606791390 | ||||||||
| Practice Location | |||||||||
| Address1: | 263 FARMINGTON AVENUE | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606793540 | ||||||||
| FaxNumber: | 8606791390 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2011 | ||||||||
| LastUpdateDate: | 09/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | LT4000 | NH | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 096153 | OH | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 062131 | CT | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.