Provider Demographics
NPI:1730926213
Name:KRZYKOWSKI, RYAN (LMT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:KRZYKOWSKI
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-1803
Mailing Address - Country:US
Mailing Address - Phone:315-207-2023
Mailing Address - Fax:
Practice Address - Street 1:3 4TH AVE
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-1803
Practice Address - Country:US
Practice Address - Phone:315-207-2023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032943173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist