Provider Demographics
NPI:1639703226
Name:HARTMAN, WILLIAM (HEARING AID DISPENSE)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:HEARING AID DISPENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 GOTHAM ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-4142
Mailing Address - Country:US
Mailing Address - Phone:315-783-8006
Mailing Address - Fax:
Practice Address - Street 1:20053 SUMMIT VIEW BLVD STE 3
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-2268
Practice Address - Country:US
Practice Address - Phone:315-783-8006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15000006650237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist