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General NPI Number Information
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NPI Number | 1689212383
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Entity Type | Individual
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Provider Name | MARYANN TULYK MSPT
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Gender | Female
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Dates
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Enumeration Date | 12/13/2019
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 1555 LONG POND RD GOLISANO RESTORATIVE NEUROLOGY AND REHABILITATION
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City | ROCHESTER
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State | NY
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Zip | 14626
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Country | US
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Telephone | 585-723-7507
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Fax | 585-368-3838
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Provider Business Mailing Address
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Address Line | 13 GALWOOD DR
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City | ROCHESTER
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State | NY
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Zip | 14622-2155
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Country | US
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Telephone | 585-467-7384
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 028370-1
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License Number State | NY
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