MEDICARE: MR. DAVID J BRZYKCY PT

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	2251X0800X	Orthopedic Physical Therapist	018350-1	NY

General Provider Information

NPI Number	:	1487650032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID J BRZYKCY PT

Provider Business Mailing Address
First Line	:	2258 SENECA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14210-2444
Country	:	US
Telephone Number	:	716-867-2138
Fax Number	:	716-826-2226

Provider Business Practice Location Address
First Line	:	2258 SENECA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14210-2444
Country	:	US
Telephone Number	:	716-867-2138
Fax Number	:	716-826-2226

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	07/08/2007

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