Provider Demographics
NPI:1003870056
Name:HRAB, DAWN PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:PATRICIA
Last Name:HRAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 RAILROAD ST
Mailing Address - Street 2:P.O. BOX 357
Mailing Address - City:CLARENCE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14032-9765
Mailing Address - Country:US
Mailing Address - Phone:716-741-8403
Mailing Address - Fax:
Practice Address - Street 1:1835 MAPLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2711
Practice Address - Country:US
Practice Address - Phone:716-634-5410
Practice Address - Fax:716-634-0430
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180631207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01827536Medicaid
NY01827536Medicaid
NYC41331Medicare ID - Type Unspecified