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General NPI Number Information
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NPI Number | 1902210677
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Entity Type | Individual
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Provider Name | RICHARD HAZEL DAC
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Gender | Male
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 2733 WEHRLE DR # 3F
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7348
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Country | US
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Telephone | 716-219-0815
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Fax |
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Provider Business Mailing Address
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Address Line | 500 SENECA ST APT 3-17
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City | BUFFALO
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State | NY
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Zip | 14204-1988
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Country | US
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Telephone | 917-664-1966
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 005308
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License Number State | NY
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