MEDICARE: DR. MICHAEL IGNATIUS HANZLY D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	2793	NY
2	213E00000X	Podiatrist	2793	NY
3	213E00000X	Podiatrist	PO 0001680	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000507505005	OTHER	NY	BLUE CROSS/ BLUE SHIELD
2	000507505004	OTHER	NY	BLUE CROSS/BLUE SHIELD
3	00010251601	OTHER	NY	UNIVERA
4	8907425	OTHER	NY	INDEPENDENT HEALTH
5	000507505008	OTHER	NY	BLUE CROSS/BLUE SHIELD
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871598326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL IGNATIUS HANZLY D.P.M.

Provider Business Mailing Address
First Line	:	2267 SENECA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14210-2517
Country	:	US
Telephone Number	:	716-823-0049
Fax Number	:	716-823-3744

Provider Business Practice Location Address
First Line	:	2267 SENECA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14210-2517
Country	:	US
Telephone Number	:	716-823-0049
Fax Number	:	716-823-3744

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	11/21/2007

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