Provider Demographics
NPI:1851042121
Name:HARTMAN - PASCIUCCO, INGRID
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:HARTMAN - PASCIUCCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 JEROME DR
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2566
Mailing Address - Country:US
Mailing Address - Phone:609-464-3594
Mailing Address - Fax:
Practice Address - Street 1:607 N JEROME AVE
Practice Address - Street 2:
Practice Address - City:MARGATE CITY
Practice Address - State:NJ
Practice Address - Zip Code:08402-1527
Practice Address - Country:US
Practice Address - Phone:609-822-1108
Practice Address - Fax:609-822-1106
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100202900106H00000X
NJ37FI00202900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist