MEDICARE: JOSHUA HARTMAN

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	207RG0100X	Gastroenterology Physician	62279	CT
2	207RG0100X	Gastroenterology Physician	283371	NY

General Provider Information

NPI Number	:	1730421355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA HARTMAN

Provider Business Mailing Address
First Line	:	540 GRAMATAN AVE
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-2104
Country	:	US
Telephone Number	:	914-668-5944
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 GRAMATAN AVE
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-2104
Country	:	US
Telephone Number	:	914-668-5944
Fax Number	:

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

Provider Enumeration Date	:	03/21/2013
Last Update Date	:	04/28/2023

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