Provider Demographics
NPI:1902990096
Name:HARTZELL, HEATHER D (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:HARTZELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 APPLESEED DR
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3652
Mailing Address - Country:US
Mailing Address - Phone:508-801-5833
Mailing Address - Fax:
Practice Address - Street 1:4 APPLESEED DR
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3652
Practice Address - Country:US
Practice Address - Phone:508-801-5833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212440207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology