Provider Demographics
NPI:1821041054
Name:HARDY, HOWARD W III (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:W
Last Name:HARDY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BLDG 3C-201
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2201
Mailing Address - Country:US
Mailing Address - Phone:609-896-1700
Mailing Address - Fax:609-896-1087
Practice Address - Street 1:3131 PRINCETON PIKE
Practice Address - Street 2:BLDG 3C-201
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2201
Practice Address - Country:US
Practice Address - Phone:609-896-1700
Practice Address - Fax:609-896-1087
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA048040208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ024945Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NJD06067Medicare UPIN