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General NPI Number Information
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NPI Number | 1073814729
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Entity Type | Organization
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Legal Business Name | THOMAS A. HASSENFRATZ DPM
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Dates
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Enumeration Date | 11/11/2010
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Last Update Date | 11/11/2010
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Provider Practice Location Address
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Address Line | 380 CLEVELAND DR
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City | BUFFALO
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State | NY
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Zip | 14215-1922
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Country | US
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Telephone | 716-836-7156
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Fax | 716-837-4112
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Provider Business Mailing Address
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Address Line | 380 CLEVELAND DR
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City | BUFFALO
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State | NY
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Zip | 15215-1922
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Country | US
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Telephone | 716-836-7156
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Fax | 716-837-4112
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS A HASSENFRATZ
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Credential | DPM
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Telephone | 716-836-7156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N002071
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License Number State | NY
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