Provider Demographics
NPI:1629392766
Name:HARTNETT, JOSEPH A
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:HARTNETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-3336
Mailing Address - Country:US
Mailing Address - Phone:302-229-9710
Mailing Address - Fax:302-401-4975
Practice Address - Street 1:800 WOODLAWN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2815
Practice Address - Country:US
Practice Address - Phone:302-428-9420
Practice Address - Fax:302-401-4975
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE177769Y0XMedicare PIN