Provider Demographics
NPI:1275529786
Name:HRISHENKO, MAUREEN LAWLOR (MD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:LAWLOR
Last Name:HRISHENKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:LAWLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 WINTERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9340
Mailing Address - Country:US
Mailing Address - Phone:412-400-0476
Mailing Address - Fax:
Practice Address - Street 1:5 WINTERBERRY LN
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-9340
Practice Address - Country:US
Practice Address - Phone:412-400-0476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY53079207RN0300X
PAMD-027654-E207RN0300X
NMMD2023-1062207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014072040006Medicaid
PA438253Q2YMedicare ID - Type Unspecified
PAC34158Medicare UPIN