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General NPI Number Information
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NPI Number | 1659208460
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Entity Type | Individual
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Provider Name | JACOB MICHAEL HARTMAN FNP
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Gender | Male
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE
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City | ROCHESTER
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State | NY
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Zip | 14642-0002
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Country | US
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Telephone | 585-275-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 1282 LEHIGH STATION RD APT 2607
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City | HENRIETTA
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State | NY
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Zip | 14467-9258
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Country | US
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Telephone | 607-857-7790
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 850028
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 360226
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License Number State | NY
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