MEDICARE: THOMAS A. HASSENFRATZ DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	N002071	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	480015008	OTHER		RR MEDICARE
3	RA0314	OTHER		MEDICARE PART B

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073814729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS A. HASSENFRATZ DPM

Provider Business Mailing Address
First Line	:	380 CLEVELAND DR
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	15215-1922
Country	:	US
Telephone Number	:	716-836-7156
Fax Number	:	716-837-4112

Provider Business Practice Location Address
First Line	:	380 CLEVELAND DR
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-1922
Country	:	US
Telephone Number	:	716-836-7156
Fax Number	:	716-837-4112

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS A HASSENFRATZ
Credential	:	DPM
Telephone Number	:	716-836-7156

Provider Enumeration Date	:	11/11/2010
Last Update Date	:	11/11/2010

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