Provider Demographics
NPI:1790780260
Name:RANA, ILAXI (OD)
Entity Type:Individual
Prefix:DR
First Name:ILAXI
Middle Name:
Last Name:RANA
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 1:140 LITTLETON RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1867
Mailing Address - Country:US
Mailing Address - Phone:973-263-3200
Mailing Address - Fax:973-263-3202
Practice Address - Street 1:140 LITTLETON RD
Practice Address - Street 2:SUITE 230
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1867
Practice Address - Country:US
Practice Address - Phone:973-263-3200
Practice Address - Fax:973-263-3202
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00578400152W00000X
NYTUV006397-1152W00000X
NJ27OA00578401152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9014403Medicaid
NJ9014403Medicaid