Healthcare Provider Details

I. General information

NPI: 1952412405
Provider Name (Legal Business Name): JEANNE HARTMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 WILLIS AVE 4
WILLISTON PARK NY
11596-2240
US

IV. Provider business mailing address

205 HARVARD ST
EAST WILLISTON NY
11596-1916
US

V. Phone/Fax

Practice location:
  • Phone: 516-294-4810
  • Fax: 516-294-4810
Mailing address:
  • Phone: 516-294-4810
  • Fax: 516-294-4810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number009351-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: