MEDICARE: DARIA BYSTRY

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	225100000X	Physical Therapist	047950	NY

General Provider Information

NPI Number	:	1982366159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARIA BYSTRY

Provider Business Mailing Address
First Line	:	12 BARBERRY RD
Second Line	:
City	:	WEST ISLIP
State	:	NY
Zip	:	11795-3911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 W MAIN ST
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8315
Country	:	US
Telephone Number	:	631-665-4560
Fax Number	:

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

Provider Enumeration Date	:	10/06/2021
Last Update Date	:	03/31/2025

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Directions to “ DARIA BYSTRY ” Practice Location

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