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General NPI Number Information
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NPI Number | 1174399596
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Entity Type | Organization
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Legal Business Name | JEFFREY D. HART DO PC
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 4200 SUNRISE HWY
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City | MASSAPEQUA
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State | NY
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Zip | 11758-5311
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Country | US
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Telephone | 833-374-2787
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 SUNRISE HWY
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City | MASSAPEQUA
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State | NY
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Zip | 11758-5311
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Country | US
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Telephone | 833-374-2787
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JEFFREY HART
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Credential | DO
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Telephone | 516-459-4671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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