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General NPI Number Information
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NPI Number | 1184160715
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Entity Type | Individual
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Provider Name | BRETT HARTMAN PSYD
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Gender | Male
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 1762 CENTRAL AVE STE 201
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City | ALBANY
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State | NY
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Zip | 12205-4777
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Country | US
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Telephone | 518-389-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 196 EUCLID AVE
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City | ALBANY
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State | NY
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Zip | 12208-1402
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Country | US
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Telephone | 518-482-6089
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 012881
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License Number State | NY
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