Healthcare Provider Details
I. General information
NPI: 1275685885
Provider Name (Legal Business Name): HART ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2007
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3407 GARRETT RD
DREXEL HILL PA
19026-2320
US
IV. Provider business mailing address
3407 GARRETT RD
DREXEL HILL PA
19026-2320
US
V. Phone/Fax
- Phone: 610-284-6400
- Fax: 610-284-4370
- Phone: 610-284-6400
- Fax: 610-284-4370
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS002146L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | OS002146L |
| License Number State | PA |
VIII. Authorized Official
Name: DR.
W.
JAMES
HART
Title or Position: PRESIDENT
Credential: D.O.
Phone: 610-284-6400