Provider Demographics
NPI:1497827877
Name:HART, PATRICIA (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-0217
Mailing Address - Country:US
Mailing Address - Phone:315-729-8936
Mailing Address - Fax:315-422-3641
Practice Address - Street 1:7548 MANLIUS CENTER RD APT 1
Practice Address - Street 2:
Practice Address - City:KIRKVILLE
Practice Address - State:NY
Practice Address - Zip Code:13082-9327
Practice Address - Country:US
Practice Address - Phone:315-729-8936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212594-1204D00000X
NY212594208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation