Provider Demographics
NPI:1316315120
Name:HART, SYRITA (CRNP, FNP)
Entity type:Individual
Prefix:
First Name:SYRITA
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:CRNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:848-288-6935
Mailing Address - Fax:732-790-0107
Practice Address - Street 1:1050 KINGS HWY N STE 105
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1909
Practice Address - Country:US
Practice Address - Phone:856-321-0303
Practice Address - Fax:856-321-0090
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00618800363LF0000X
PASP015063363LF0000X
NJ26NR18321300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0688118Medicaid