Provider Demographics
NPI:1922660257
Name:HARTELL, PHOEBE FAM
Entity Type:Individual
Prefix:DR
First Name:PHOEBE
Middle Name:FAM
Last Name:HARTELL
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 1:6 MOUNTAIN TOP TER
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2058
Mailing Address - Country:US
Mailing Address - Phone:347-581-4377
Mailing Address - Fax:
Practice Address - Street 1:103 CARNEGIE CTR STE 300
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6235
Practice Address - Country:US
Practice Address - Phone:888-964-6681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist