Provider Demographics
NPI:1073522157
Name:HARTMAN, ROSS (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-1707
Mailing Address - Country:US
Mailing Address - Phone:917-922-3181
Mailing Address - Fax:
Practice Address - Street 1:400 S OYSTER BAY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3500
Practice Address - Country:US
Practice Address - Phone:516-822-3338
Practice Address - Fax:516-935-9405
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-06
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005926213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV00237Medicare UPIN
NYPJ4101Medicare ID - Type UnspecifiedEMPIRE MEDICARE
NY06447Medicare ID - Type UnspecifiedGHI MEDICARE