Provider Demographics
NPI:1447254917
Name:HARTMAN, PAUL JAMES (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:JAMES
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 CLINTON AVE S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2616
Mailing Address - Country:US
Mailing Address - Phone:585-244-6011
Mailing Address - Fax:585-244-0236
Practice Address - Street 1:2100 CLINTON AVE S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2616
Practice Address - Country:US
Practice Address - Phone:585-244-6011
Practice Address - Fax:585-244-0236
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207199207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY180030304OtherRAILROAD MEDICARE
NY1447254917OtherMVP
NYP010207199OtherBCBS
NY01760503Medicaid
NY1073577961OtherEXCELLUS BCBS
NY180030304OtherRAILROAD MEDICARE
NY1447254917OtherMVP