Provider Demographics
NPI:1144889890
Name:HART, JAIME ANN (RD, CDE, CDN)
Entity type:Individual
Prefix:
First Name:JAIME ANN
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:RD, CDE, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 E MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8441
Mailing Address - Country:US
Mailing Address - Phone:631-396-7000
Mailing Address - Fax:631-396-7026
Practice Address - Street 1:376 E MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8441
Practice Address - Country:US
Practice Address - Phone:631-396-7000
Practice Address - Fax:631-396-7026
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered