Healthcare Provider Details

I. General information

NPI: 1528463577
Provider Name (Legal Business Name): RONI HARTMAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2014
Last Update Date: 11/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 S GREELEY AVE SUITE 302
CHAPPAQUA NY
10514-3346
US

IV. Provider business mailing address

1 S GREELEY AVE SUITE 302
CHAPPAQUA NY
10514-3346
US

V. Phone/Fax

Practice location:
  • Phone: 914-238-1699
  • Fax: 914-238-1695
Mailing address:
  • Phone: 914-238-1699
  • Fax: 914-238-1695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR036003
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: