Provider Demographics
NPI:1477228138
Name:HARTMAN, LAUREN NICOLE (MA)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:NICOLE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-4813
Mailing Address - Country:US
Mailing Address - Phone:631-704-8973
Mailing Address - Fax:
Practice Address - Street 1:6800 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4436
Practice Address - Country:US
Practice Address - Phone:516-393-5966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYUSU000217845OtherBLUECROSS BLUESHIELD