# HERNANDEZ PODIATRY P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174748677
- **Authorized official:** WILLIAM A HERNANDEZ DPM (PODIATRIST)
- **Authorized official phone:** (631) 968-6300

## Contact information

- **Practice address:** 85 W MAIN ST, SUITE 102, BAY SHORE, NY 11706-8345
- **Practice address phone:** (631) 968-6300
- **Practice address fax:** (631) 968-5886
- **Mailing address:** 85 W MAIN ST, SUITE 102, BAY SHORE, NY 11706-8345
- **Mailing address phone:** (631) 968-6300
- **Mailing address fax:** (631) 968-5886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 07/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01098342 | — | NY |
| 01 | — | 11151 | VYTRA | NY |
| 01 | — | CJ2956 | RAILROAD MEDICARE | NY |
| 01 | — | CS816 | OXFORD | NY |