Healthcare Provider Details

I. General information

NPI: 1952550394
Provider Name (Legal Business Name): TIMOTHY DWIGHT PARYSEK MSPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 09/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 WESTFALL RD
ROCHESTER NY
14620-4610
US

IV. Provider business mailing address

52 SCARBOROUGH PARK
ROCHESTER NY
14625-1365
US

V. Phone/Fax

Practice location:
  • Phone: 585-461-8500
  • Fax: 585-461-8545
Mailing address:
  • Phone: 585-461-1850
  • Fax: 585-461-8545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number030530-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: