Provider Demographics
NPI:1407832322
Name:HAWK, ROBERT (CRNA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HAWK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WHITE HORSE RD STE 612
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4412
Mailing Address - Country:US
Mailing Address - Phone:564-513-5528
Mailing Address - Fax:610-254-9501
Practice Address - Street 1:93 COOPER RD STE 100
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4910
Practice Address - Country:US
Practice Address - Phone:856-770-1920
Practice Address - Fax:856-770-1925
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN248693L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
S61577Medicare UPIN
PA008319Medicare ID - Type Unspecified