Provider Demographics
NPI:1720107741
Name:HAWRUK, ELIZABETH A (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:HAWRUK
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 1:45 CAREY AVE
Mailing Address - Street 2:STE 250
Mailing Address - City:BUTLER
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-1475
Mailing Address - Country:US
Mailing Address - Phone:973-283-2700
Mailing Address - Fax:973-283-2707
Practice Address - Street 1:45 CAREY AVE
Practice Address - Street 2:STE 250
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-1475
Practice Address - Country:US
Practice Address - Phone:973-283-2700
Practice Address - Fax:973-283-2707
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C63221Medicare UPIN