Provider Demographics
NPI:1598827206
Name:GAW, ELIZABETH ELAINE
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ELAINE
Last Name:GAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BRISTOL ST
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4703
Mailing Address - Country:US
Mailing Address - Phone:603-474-7195
Mailing Address - Fax:
Practice Address - Street 1:270 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4542
Practice Address - Country:US
Practice Address - Phone:603-474-2514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist