Provider Demographics
NPI:1841220753
Name:HITZEL, HOWARD K (PSY D)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:K
Last Name:HITZEL
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4915
Mailing Address - Country:US
Mailing Address - Phone:716-316-8774
Mailing Address - Fax:
Practice Address - Street 1:229 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4915
Practice Address - Country:US
Practice Address - Phone:716-316-8774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013500-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00027629201OtherUNIVERA HEALTHCARE
NY000525711001OtherBLUE CROSS BLUE SHIELD
NY0001132209OtherMHN SERVICES
NY6112480OtherINDEPENDENT HEALTH
NY6112480OtherINDEPENDENT HEALTH