Provider Demographics
NPI:1982042628
Name:HAWKINS MEDICAL PRACTICE PC
Entity Type:Organization
Organization Name:HAWKINS MEDICAL PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:212-768-1600
Mailing Address - Street 1:20 W 38TH ST
Mailing Address - Street 2:300
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6228
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:312 11TH AVE
Practice Address - Street 2:APT. 7U
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1221
Practice Address - Country:US
Practice Address - Phone:212-768-1600
Practice Address - Fax:212-768-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259311207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty