Provider Demographics
NPI:1659823912
Name:JEANNE HARTMAN, PH.D., PSYCHOLOGIST, LLC
Entity Type:Organization
Organization Name:JEANNE HARTMAN, PH.D., PSYCHOLOGIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-294-4810
Mailing Address - Street 1:99 HILLSIDE AVE
Mailing Address - Street 2:SUITE 99L
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2333
Mailing Address - Country:US
Mailing Address - Phone:516-294-4810
Mailing Address - Fax:516-294-4810
Practice Address - Street 1:99 HILLSIDE AVE
Practice Address - Street 2:SUITE 99L
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2333
Practice Address - Country:US
Practice Address - Phone:516-294-4810
Practice Address - Fax:516-294-4810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009351-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1952412405OtherNPI