Provider Demographics
NPI:1992856397
Name:HASSENFRATZ, JAY T (DPM)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:T
Last Name:HASSENFRATZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 UNION RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3445
Mailing Address - Country:US
Mailing Address - Phone:716-712-0851
Mailing Address - Fax:716-712-0853
Practice Address - Street 1:1026 UNION RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3445
Practice Address - Country:US
Practice Address - Phone:716-712-0851
Practice Address - Fax:716-712-0853
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005872-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000526791007OtherHEALTHNOW
NY7430364OtherAETNA
NY000526791010OtherBC/BS
NY480015008OtherRAILROAD MEDICARE
NY00026000303OtherUNIVERA
NY000526791009OtherHEALTHNOW DME
NY000526791006OtherHEALTHNOW
NY000526791011OtherBC/BS DME
NY160918194OtherTRICARE
NYP05872-8WOtherWORKERS COMPENSATION
NY000526791008OtherHEALTHNOW
NY02324532Medicaid
NY142517EQOtherPREF CARE
NY00026000302OtherUNIVERA
NY0086185OtherGHI
NYP05872-8WOtherWORKERS COMPENSATION
NY160918194OtherTRICARE
NY160918194OtherTRICARE