MEDICARE: BETHANY HARTNETT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	026630-1	NY

General Provider Information

NPI Number	:	1518467687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY HARTNETT

Provider Business Mailing Address
First Line	:	31 HARTS HILL CIR
Second Line	:
City	:	WHITESBORO
State	:	NY
Zip	:	13492-2417
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2439 SLATERVILLE RD
Second Line	:
City	:	SLATERVILLE SPRINGS
State	:	NY
Zip	:	14881-9402
Country	:	US
Telephone Number	:	607-539-7155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2018
Last Update Date	:	02/15/2018

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Directions to “ BETHANY HARTNETT ” Practice Location

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