Provider Demographics
NPI:1609860089
Name:STAWOWY, HANIA W (MD)
Entity Type:Individual
Prefix:
First Name:HANIA
Middle Name:W
Last Name:STAWOWY
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:PO BOX 8915
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-0915
Mailing Address - Country:US
Mailing Address - Phone:518-489-3296
Mailing Address - Fax:518-489-4663
Practice Address - Street 1:319 SOUTH MANNING BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1743
Practice Address - Country:US
Practice Address - Phone:518-498-3296
Practice Address - Fax:518-489-4663
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147043174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01072691Medicaid
NYC49884Medicare UPIN
NY01072691Medicaid