Active NPI
Frederick Hazlett, LMT
- Massage Therapist
- Conklin, NY
National Provider Identifier
1306223540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 012761-1
- Practice address
- 1213 Conklin Rd
Conklin, NY 13748-1405 - Phone
- (607) 775-0178
- NPI assigned
- Apr 27, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 012761-1 | NY | Primary |
Addresses
Primary practice location
1213 Conklin Rd
Conklin, NY 13748-1405
Mailing address
1213 Conklin Rd
Conklin, NY 13748-1405
Phone (607) 775-0178
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012761-1 | NY | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430092800000",
"number": "1306223540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 CONKLIN RD",
"city": "CONKLIN",
"state": "NY",
"postal_code": "137481405",
"telephone_number": "607-775-0178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 CONKLIN RD",
"city": "CONKLIN",
"state": "NY",
"postal_code": "137481405",
"telephone_number": "607-775-0178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZLETT",
"first_name": "FREDERICK",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-27",
"last_updated": "2015-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "012761-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conklin, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.