Provider Demographics
NPI:1033624465
Name:HAWS, MILO (TMBT)
Entity Type:Individual
Prefix:
First Name:MILO
Middle Name:
Last Name:HAWS
Suffix:
Gender:M
Credentials:TMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3209
Mailing Address - Country:US
Mailing Address - Phone:609-271-4713
Mailing Address - Fax:
Practice Address - Street 1:225 E STATE ST STE 12
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08608-1800
Practice Address - Country:US
Practice Address - Phone:609-695-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00496600163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)