MEDICARE: MICHAEL I. HANZLY DPM PC

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	2793	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00010251601	OTHER	NY	UNIVERA
2	U00029	OTHER	NY	UPIN
3	00507505005	OTHER	NY	BLUE CROSS/BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8907425	OTHER	NY	INDEPENDENT HEALTH

General Provider Information

NPI Number	:	1356664627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL I. HANZLY DPM PC

Provider Business Mailing Address
First Line	:	2267 SENECA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14210-2517
Country	:	US
Telephone Number	:	716-823-0049
Fax Number	:	716-823-3744

Provider Business Practice Location Address
First Line	:	2267 SENECA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14210-2517
Country	:	US
Telephone Number	:	716-823-0049
Fax Number	:	716-823-3744

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL I HANZLY
Credential	:	D.P.M.
Telephone Number	:	716-823-0049

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	03/01/2010

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