Provider Demographics
NPI:1043445745
Name:HAUCK, ROBIN ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:ELIZABETH
Last Name:HAUCK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1942
Mailing Address - Country:US
Mailing Address - Phone:201-327-3006
Mailing Address - Fax:201-327-0720
Practice Address - Street 1:245 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1942
Practice Address - Country:US
Practice Address - Phone:201-327-3006
Practice Address - Fax:201-327-0720
Is Sole Proprietor?:No
Enumeration Date:2009-05-25
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007505152W00000X
NJ27OA00638500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist