Healthcare Provider Details

I. General information

NPI: 1740211242
Provider Name (Legal Business Name): AARON A HRYCKO PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12845 BROADWAY ST STE 2
ALDEN NY
14004-1223
US

IV. Provider business mailing address

12845 BROADWAY ST STE 2
ALDEN NY
14004-1223
US

V. Phone/Fax

Practice location:
  • Phone: 716-902-5068
  • Fax: 716-902-4050
Mailing address:
  • Phone: 716-902-5068
  • Fax: 716-902-4050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number021029
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: