Provider Demographics
NPI:1063881738
Name:HART, EMILY (LPT)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:K
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPT
Mailing Address - Street 1:1000 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4739
Mailing Address - Country:US
Mailing Address - Phone:401-533-9100
Mailing Address - Fax:401-533-9105
Practice Address - Street 1:1000 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-4739
Practice Address - Country:US
Practice Address - Phone:401-533-9101
Practice Address - Fax:401-533-9105
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02841225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0614OtherNHPRI
RISB870OtherBCBSRI
RIES01788Medicaid