MEDICARE: ERIN PYTLAK MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1013495928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN PYTLAK MS

Provider Business Mailing Address
First Line	:	1099 JAY ST STE 202
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14611-1153
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1099 JAY ST STE 202
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14611-1153
Country	:	US
Telephone Number	:	585-328-0834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2018
Last Update Date	:	08/02/2018

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