Healthcare Provider Details

I. General information

NPI: 1124647953
Provider Name (Legal Business Name): HARTMAN CENTER FOR FUNCTIONAL NEUROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2020
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

682 TAYLOR AVE
ORADELL NJ
07649-2549
US

IV. Provider business mailing address

682 TAYLOR AVE
ORADELL NJ
07649-2549
US

V. Phone/Fax

Practice location:
  • Phone: 201-803-6027
  • Fax:
Mailing address:
  • Phone: 201-803-6027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN HARTMAN
Title or Position: OWNER
Credential: DC
Phone: 201-692-7246