Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MA38070 | NJ |
NPI | 1164488284 |
---|---|
Provider Name | Dr. Patricia Hicks Hartman |
First Address | Westfield, NJ 07090-1001 |
Second Address | Westfield, NJ 07090-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 03/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C56319 | (02) | NJ |