Healthcare Provider Details

I. General information

NPI: 1700715653
Provider Name (Legal Business Name): PATRICK HAZARD DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3639 W WOOLBRIGHT RD
BOYNTON BEACH FL
33436-7244
US

IV. Provider business mailing address

15 WESTON DR
PITTSTOWN NJ
08867-5149
US

V. Phone/Fax

Practice location:
  • Phone: 561-404-0203
  • Fax:
Mailing address:
  • Phone: 908-246-4403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: