Provider Demographics
NPI:1710031794
Name:KACZOROWSKI, LYNN ANN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:ANN
Last Name:KACZOROWSKI
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8000
Mailing Address - Street 2:DEPT. 839
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0002
Mailing Address - Country:US
Mailing Address - Phone:716-882-3300
Mailing Address - Fax:716-882-3484
Practice Address - Street 1:235 NORTH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1401
Practice Address - Country:US
Practice Address - Phone:716-882-3300
Practice Address - Fax:716-882-3484
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY029061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist