Provider Demographics
NPI:1013913003
Name:HARTENSTEIN, ROBERT W (AUD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:HARTENSTEIN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 ALLEN ST
Mailing Address - Street 2:STE 2
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4564
Mailing Address - Country:US
Mailing Address - Phone:802-773-8469
Mailing Address - Fax:802-773-0017
Practice Address - Street 1:69 ALLEN ST
Practice Address - Street 2:STE 2
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4564
Practice Address - Country:US
Practice Address - Phone:802-773-8469
Practice Address - Fax:802-773-0017
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1427231H00000X
VT063-0000044237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00007947OtherBLUE CROSS
VT00007321Medicaid
VT00007947Medicaid
VT00007321OtherBLUE CROSS
VT0275359-001OtherCIGNA
VT00007321Medicaid