Healthcare Provider Details

I. General information

NPI: 1841213881
Provider Name (Legal Business Name): JOHN C HARTMAN OT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 STATE ROUTE 332
FARMINGTON NY
14425-1077
US

IV. Provider business mailing address

235 ALEXANDER ST
ROCHESTER NY
14607-2501
US

V. Phone/Fax

Practice location:
  • Phone: 585-924-3642
  • Fax: 585-742-2559
Mailing address:
  • Phone: 585-263-2850
  • Fax: 585-263-2885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number006330
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: