Provider Demographics
NPI:1578868659
Name:HARTMAN, MARIKA W
Entity Type:Individual
Prefix:
First Name:MARIKA
Middle Name:W
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 LANGHORNE-NEWTOWN RD STE 402
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-750-7000
Mailing Address - Fax:215-750-9572
Practice Address - Street 1:1717 LANGHORNE-NEWTOWN RD STE 402
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-750-7000
Practice Address - Fax:215-750-9572
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011101363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health