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General NPI Number Information
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NPI Number | 1659823912
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Entity Type | Organization
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Legal Business Name | JEANNE HARTMAN, PH.D., PSYCHOLOGIST, LLC
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 99 HILLSIDE AVE SUITE 99L
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City | WILLISTON PARK
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State | NY
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Zip | 11596-2333
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Country | US
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Telephone | 516-294-4810
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Fax | 516-294-4810
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Provider Business Mailing Address
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Address Line | 99 HILLSIDE AVE SUITE 99L
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City | WILLISTON PARK
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State | NY
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Zip | 11596-2333
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Country | US
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Telephone | 516-294-4810
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Fax | 516-294-4810
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JEANNE HARTMAN
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Credential | PH.D.
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Telephone | 516-294-4810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 009351-1
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License Number State | NY
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