Healthcare Provider Details

I. General information

NPI: 1821041054
Provider Name (Legal Business Name): HOWARD W HARDY III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 PRINCETON PIKE BLDG 3C-201
LAWRENCEVILLE NJ
08648-2201
US

IV. Provider business mailing address

3131 PRINCETON PIKE BLDG 3C-201
LAWRENCEVILLE NJ
08648-2201
US

V. Phone/Fax

Practice location:
  • Phone: 609-896-1700
  • Fax: 609-896-1087
Mailing address:
  • Phone: 609-896-1700
  • Fax: 609-896-1087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMA048040
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: