Provider Demographics
NPI:1801808878
Name:HART, DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:HART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-7616
Mailing Address - Country:US
Mailing Address - Phone:914-831-6880
Mailing Address - Fax:914-831-6881
Practice Address - Street 1:73 MARKET ST
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7616
Practice Address - Country:US
Practice Address - Phone:914-831-6880
Practice Address - Fax:914-831-6881
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187766207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01888242Medicaid
NY719021Medicare PIN
G45379Medicare UPIN
NY719021Medicare PIN
NY187766OtherHIP
G45379Medicare UPIN
NY060045208OtherRAILROAD MEDICARE
10341OtherCONTRACT MANAGEMENT ORGAN
NYP602271OtherOXFORD HEALTH PLAN
6223900010OtherCIGNA
187766NYOtherLOCAL 1199
000000043616OtherGHI HMO
1737308OtherUNITED HEALTHCARE
6015127OtherGHI PPO CBP