Individual
MS. NICOLE M HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5501 OLD YORK RD, LIFTER BUILDING FIRST FLOOR, PHILADELPHIA, PA 19141-3018
(215) 456-6810
Mailing address
5501 OLD YORK RD, LIFTER BUILDING FIRST FLOOR, PHILADELPHIA, PA 19141-3018
(215) 456-6810
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA050946
PA
Other
Enumeration date
03/17/2011
Last updated
03/17/2011
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