Provider Demographics
NPI:1386798254
Name:HARTZFELD, BRUCE O (DC)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:O
Last Name:HARTZFELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-4344
Mailing Address - Country:US
Mailing Address - Phone:716-693-4916
Mailing Address - Fax:716-692-5613
Practice Address - Street 1:579 OLIVER ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-4344
Practice Address - Country:US
Practice Address - Phone:716-693-4916
Practice Address - Fax:716-692-5613
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX1971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
BH74033Medicare UPIN