Provider Demographics
NPI:1255397576
Name:HIBBETT, ELIZABETH D (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:D
Last Name:HIBBETT
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 1:27 SPRINGTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3345
Mailing Address - Country:US
Mailing Address - Phone:973-634-3397
Mailing Address - Fax:
Practice Address - Street 1:65 JAMES ST
Practice Address - Street 2:JFK MEDICAL CENTER
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3947
Practice Address - Country:US
Practice Address - Phone:732-321-7487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07609800207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0010910Medicaid
NJ075182B3LMedicare ID - Type Unspecified
NJ0010910Medicaid