MEDICARE: DR. AYNN B. HARTMAN PH.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	103TC0700X	Clinical Psychologist	3983	NJ

General Provider Information

NPI Number	:	1518025592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AYNN B. HARTMAN PH.D.

Provider Business Mailing Address
First Line	:	28 MILLBURN AVE
Second Line	:	SHORT HILLS ASSOCIATES
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-1039
Country	:	US
Telephone Number	:	973-467-9333
Fax Number	:	973-467-1145

Provider Business Practice Location Address
First Line	:	28 MILLBURN AVE
Second Line	:	SHORT HILLS ASSOCIATES
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-1039
Country	:	US
Telephone Number	:	973-467-9333
Fax Number	:	973-467-1145

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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