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Lydia Anne Hawk

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3700 Route 33, Suite 101, Neptune, NJ 07753

PECOS Enrollment

This provider is enrolled in PECOS as LYDIA HAWK.

Based on the most recent information from CMS, provider Lydia Anne Hawk is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1073293817
Provider Type
Individual
Full Name
Hawk, Lydia Anne
Credential
PA-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/18/2023
Last Updated
1/11/2024

Contact Information

Practice Location

3700 Route 33, Suite 101, Neptune, NJ 07753

(732) 280-7855

Unlisted Fax

Mailing Location

16 Johnston Ave, Brick, NJ 08724

(732) 489-9828

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Lydia Anne Hawk

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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