Healthcare Provider Details

I. General information

NPI: 1124261649
Provider Name (Legal Business Name): CHRISTINE HUZYK LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3183 CHILI AVE
ROCHESTER NY
14624-5409
US

IV. Provider business mailing address

3183 CHILI AVE
ROCHESTER NY
14624-5409
US

V. Phone/Fax

Practice location:
  • Phone: 585-957-6776
  • Fax:
Mailing address:
  • Phone: 585-957-6776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number022947
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: