Provider Demographics
NPI:1457883886
Name:HARTMANN, NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HARTMANN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 PRINCETON PIKE FL 2
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2325
Mailing Address - Country:US
Mailing Address - Phone:609-896-1701
Mailing Address - Fax:609-896-3735
Practice Address - Street 1:3120 PRINCETON PIKE FL 2
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2325
Practice Address - Country:US
Practice Address - Phone:609-896-1701
Practice Address - Fax:609-896-3735
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB118478002084E0001X, 2084N0400X
PAOS0212832084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology