Basic Information
Provider Information
NPI: 1053048165
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARTMAN
FirstName: BRITTANY
MiddleName:  
NamePrefix: MISS
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2400 WILDWOOD RD
Address2:  
City: GIBSONIA
State: PA
PostalCode: 150446404
CountryCode: US
TelephoneNumber: 4125193625
FaxNumber:  
Practice Location
Address1: 2400 WILDWOOD RD
Address2:  
City: GIBSONIA
State: PA
PostalCode: 150446404
CountryCode: US
TelephoneNumber: 4125193625
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/08/2022
LastUpdateDate: 08/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0200XOC018526PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics

No ID Information.


Home