Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 212594-1 | NY |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 212594 | NY |
NPI | 1497827877 |
---|---|
Provider Name | Dr. Patricia Hart |
First Address | Manlius, NY 13104-0217 |
Second Address | Syracuse, NY 13219-3233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/11/2013 |