Provider Demographics
NPI:1225161904
Name:HART, AMY L (SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:HART
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 EVERETT ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2650
Mailing Address - Country:US
Mailing Address - Phone:401-295-5995
Mailing Address - Fax:
Practice Address - Street 1:420 SCRABBLETOWN RD
Practice Address - Street 2:SUITE H
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-3638
Practice Address - Country:US
Practice Address - Phone:401-295-5995
Practice Address - Fax:401-295-8700
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00146-P235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI413346Medicare UPIN
RI31527-2Medicare UPIN
RI4600075Medicare UPIN
RI10428Medicare UPIN