Healthcare Provider Details

I. General information

NPI: 1487650032
Provider Name (Legal Business Name): DAVID J BRZYKCY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2258 SENECA ST
BUFFALO NY
14210-2444
US

IV. Provider business mailing address

2258 SENECA ST
BUFFALO NY
14210-2444
US

V. Phone/Fax

Practice location:
  • Phone: 716-867-2138
  • Fax: 716-826-2226
Mailing address:
  • Phone: 716-867-2138
  • Fax: 716-826-2226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number018350-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: