Provider Demographics
NPI:1649420837
Name:HART, TOYA MARI (PT)
Entity Type:Individual
Prefix:MISS
First Name:TOYA
Middle Name:MARI
Last Name:HART
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 BEN FRANKLIN BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2167
Mailing Address - Country:US
Mailing Address - Phone:919-479-8730
Mailing Address - Fax:919-479-8782
Practice Address - Street 1:4125 BEN FRANKLIN BLVD
Practice Address - Street 2:SUITE 180
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2167
Practice Address - Country:US
Practice Address - Phone:919-479-8730
Practice Address - Fax:919-479-8782
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11847174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPENDINGMedicaid
NC346512Medicare Oscar/Certification