Healthcare Provider Details

I. General information

NPI: 1134748882
Provider Name (Legal Business Name): PATRICK DANIEL HAZARD PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COMMERCE DR
NORTHBRIDGE MA
01534-1415
US

IV. Provider business mailing address

9 INDUSTRIAL RD STE 5
MILFORD MA
01757-3736
US

V. Phone/Fax

Practice location:
  • Phone: 508-234-6311
  • Fax:
Mailing address:
  • Phone: 508-473-1480
  • Fax: 508-473-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA7992
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA7992
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: