Provider Demographics
NPI:1013976273
Name:HART, DOREEN ANGELLA (NP)
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:ANGELLA
Last Name:HART
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:39 BROADWAY
Mailing Address - Street 2:SUITE 1710
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-3003
Mailing Address - Country:US
Mailing Address - Phone:212-809-0500
Mailing Address - Fax:212-809-7355
Practice Address - Street 1:39 BROADWAY
Practice Address - Street 2:SUITE 1710
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-3003
Practice Address - Country:US
Practice Address - Phone:212-809-0500
Practice Address - Fax:212-809-7355
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY332936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily