Individual provider Active NPI

Jennifer Hardatt

  • Specialist
  • Island Park, NY
National Provider Identifier
1104267152
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ESJ1739 Issued in NY
Practice address
50 Empire Blvd
Island Park, NY 11558-1228
Phone
(516) 992-5060
NPI assigned
Jul 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ESJ1739 NY Primary

Addresses

Primary practice location

50 Empire Blvd
Island Park, NY 11558-1228

Mailing address

50 Empire Blvd
Island Park, NY 11558-1228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ESJ1739NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1104267152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 EMPIRE BLVD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 EMPIRE BLVD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581228",
            "telephone_number": "516-992-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDATT",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-07",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "ESJ1739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Island Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.