Provider Demographics
NPI:1760742316
Name:HANNY HERNANDEZ DPM, P.C.
Entity Type:Organization
Organization Name:HANNY HERNANDEZ DPM, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HANNY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-403-6376
Mailing Address - Street 1:3880 ORLOFF AVE
Mailing Address - Street 2:7L
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2620
Mailing Address - Country:US
Mailing Address - Phone:917-403-6376
Mailing Address - Fax:866-902-6611
Practice Address - Street 1:2360 AMSTERDAM AVE
Practice Address - Street 2:SUITE1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-7362
Practice Address - Country:US
Practice Address - Phone:917-403-6376
Practice Address - Fax:866-902-6611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006334213ES0103X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty