Healthcare Provider Details

I. General information

NPI: 1760742316
Provider Name (Legal Business Name): HANNY HERNANDEZ DPM, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1262 BOSTON RD
BRONX NY
10456-3541
US

IV. Provider business mailing address

1262 BOSTON RD
BRONX NY
10456-3541
US

V. Phone/Fax

Practice location:
  • Phone: 917-403-6376
  • Fax: 866-902-6611
Mailing address:
  • Phone: 347-862-9092
  • Fax: 866-902-6611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number006334
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number006334
License Number StateNY

VIII. Authorized Official

Name: HANNY M HERNANDEZ
Title or Position: PODIATRIST/CEO
Credential: DPM
Phone: 347-862-9092