Basic Information
Provider Information
NPI: 1770600025
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARTMAN
FirstName: TAMAR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4241 STILMORE RD
Address2:  
City: SOUTH EUCLID
State: OH
PostalCode: 441213131
CountryCode: US
TelephoneNumber: 2166910002
FaxNumber:  
Practice Location
Address1: 20265 EMERY RD
Address2:  
City: NORTH RANDALL
State: OH
PostalCode: 441284122
CountryCode: US
TelephoneNumber: 2164758880
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/23/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XSP7588OHY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


Home