Provider Demographics
NPI:1659492056
Name:HARTMANN, ALFRED A (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:A
Last Name:HARTMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E 83RD ST APT 11E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7246
Mailing Address - Country:US
Mailing Address - Phone:212-744-9419
Mailing Address - Fax:212-290-3933
Practice Address - Street 1:1250 BROADWAY 7TH FLOOR
Practice Address - Street 2:VISITING NURSE SERVICE HOSPICE PROGRAM
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:917-921-2078
Practice Address - Fax:212-290-3933
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101562207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB80637Medicare UPIN