Provider Demographics
NPI:1215526710
Name:HARTMAN, TRISHA (RPH)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 ROUTE 206 STE 9
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-3558
Mailing Address - Country:US
Mailing Address - Phone:609-859-5633
Mailing Address - Fax:609-859-5636
Practice Address - Street 1:1805 ROUTE 206 STE 9
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08088-3558
Practice Address - Country:US
Practice Address - Phone:609-859-5633
Practice Address - Fax:609-859-5636
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03120600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist