Doctor Name: | FREDRIC CHARLES HARTMAN |
NPI Number: | 1053422824 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 009350-1 |
Business Practice Address: | 436 Willis Ave 4 Williston Park, NY - 115962240 |
Business Phone Number: | 5167462487 |
Business Fax Number: | 5162944810 |
Mailing Address: | 205 Harvard St, EAST WILLISTON |
State: | NY |
Postal Code: | 115961916 |
Phone Number: | 5167462487 |
Fax Number: | 5162944810 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 009350-1 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |