Provider Demographics
NPI:1619609229
Name:ALEGADO, HANNAH T (OD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:T
Last Name:ALEGADO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:EAP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:6800 E MAYO BLVD APT 1108
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-5618
Mailing Address - Country:US
Mailing Address - Phone:909-973-8125
Mailing Address - Fax:
Practice Address - Street 1:7700 W ARROWHEAD TOWNE CTR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8616
Practice Address - Country:US
Practice Address - Phone:210-289-8235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2593152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist