Provider Demographics
NPI:1528233699
Name:ELEWA, HANY M (DC PHD NCEA DIP)
Entity type:Individual
Prefix:DR
First Name:HANY
Middle Name:M
Last Name:ELEWA
Suffix:
Gender:M
Credentials:DC PHD NCEA DIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N10548 CTY G
Mailing Address - Street 2:
Mailing Address - City:NEW HOLSTEIN
Mailing Address - State:WI
Mailing Address - Zip Code:53061
Mailing Address - Country:US
Mailing Address - Phone:920-898-9735
Mailing Address - Fax:920-898-4258
Practice Address - Street 1:N10548 CTY G
Practice Address - Street 2:
Practice Address - City:NEW HOLSTEIN
Practice Address - State:WI
Practice Address - Zip Code:53061
Practice Address - Country:US
Practice Address - Phone:920-898-9735
Practice Address - Fax:920-898-4258
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI266055171100000X
WI2966012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIU47699Medicare UPIN