MEDICARE: MARTIN R KOSLOSKY ,PT ,P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1720536246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN R KOSLOSKY ,PT ,P.C.

Provider Business Mailing Address
First Line	:	2625 DELAWARE AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14216-1705
Country	:	US
Telephone Number	:	716-874-2759
Fax Number	:	716-874-2913

Provider Business Practice Location Address
First Line	:	2625 DELAWARE AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14216-1705
Country	:	US
Telephone Number	:	716-874-2759
Fax Number	:	716-874-2913

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARTIN R KOSLOSKY
Credential	:	PT
Telephone Number	:	716-874-2759

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	09/13/2016

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