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NPI Code Detail

MEDICARE: KRISTIN GOLISZEK MS, OTR/L

MEDICARE: KRISTIN GOLISZEK MS, OTR/L
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
1225XP0200XPediatric Occupational Therapist017203NY

General Provider Information

NPI Number : 1306118203
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN GOLISZEK MS, OTR/L
Provider Business Mailing Address
First Line : 777 MARYVALE DR
Second Line :
City : CHEEKTOWAGA
State : NY
Zip : 14225-2712
Country : US
Telephone Number : 716-677-9515
Fax Number :
Provider Business Practice Location Address
First Line : 777 MARYVALE DR
Second Line :
City : CHEEKTOWAGA
State : NY
Zip : 14225-2712
Country : US
Telephone Number : 716-677-9515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2012
Last Update Date : 11/24/2014

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