Healthcare Provider Details

I. General information

NPI: 1457347361
Provider Name (Legal Business Name): MICHAEL R HUTZEL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 MERRICK RD
SEAFORD NY
11783-2811
US

IV. Provider business mailing address

3650 MERRICK RD
SEAFORD NY
11783-2811
US

V. Phone/Fax

Practice location:
  • Phone: 516-221-5982
  • Fax: 516-221-0729
Mailing address:
  • Phone: 516-221-5982
  • Fax: 516-221-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN004996
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: