Healthcare Provider Details

I. General information

NPI: 1255314209
Provider Name (Legal Business Name): GEORGE HARDART MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 BROADWAY
NEW YORK NY
10032-1559
US

IV. Provider business mailing address

4 LOCUST LN
BRONXVILLE NY
10708-4916
US

V. Phone/Fax

Practice location:
  • Phone: 212-304-7250
  • Fax:
Mailing address:
  • Phone: 914-793-7895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number189927
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number189927
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: