MEDICARE: DAVID HART M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0207X	Pediatric Hematology & Oncology Physician	125095	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104814813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID HART M.D.

Provider Business Mailing Address
First Line	:	874 BROADWAY
Second Line	:	APT. 601
City	:	NEW YORK
State	:	NY
Zip	:	10003-1222
Country	:	US
Telephone Number	:	917-572-0138
Fax Number	:

Provider Business Practice Location Address
First Line	:	874 BROADWAY
Second Line	:	APT. 601
City	:	NEW YORK
State	:	NY
Zip	:	10003-1222
Country	:	US
Telephone Number	:	917-572-0138
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	12/29/2011

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Directions to “ DAVID HART M.D.” Practice Location

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