Provider Demographics
NPI:1497975957
Name:HARTNETT, DEBRA (NP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:HARTNETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:ONKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:52 CLIFFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2505
Mailing Address - Country:US
Mailing Address - Phone:646-522-9573
Mailing Address - Fax:
Practice Address - Street 1:301 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8408
Practice Address - Country:US
Practice Address - Phone:646-522-9573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily