Provider Demographics
NPI:1588016117
Name:I HART HEALTH PHYSICIAN ASSISTANT SERVICES PLLC
Entity Type:Organization
Organization Name:I HART HEALTH PHYSICIAN ASSISTANT SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUSI
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:844-263-4253
Mailing Address - Street 1:66 MIDDLEBUSH RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4098
Mailing Address - Country:US
Mailing Address - Phone:844-263-4253
Mailing Address - Fax:844-218-9222
Practice Address - Street 1:66 MIDDLEBUSH RD
Practice Address - Street 2:SUITE 106
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4098
Practice Address - Country:US
Practice Address - Phone:844-263-4253
Practice Address - Fax:844-218-9222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty