Provider Demographics
NPI:1104079763
Name:KRYGER, BETHANY M (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:M
Last Name:KRYGER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:1 ADLER DR
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-1223
Mailing Address - Country:US
Mailing Address - Phone:315-701-7900
Mailing Address - Fax:315-701-7901
Practice Address - Street 1:2100 BRIGHTON HENRIETTA TOWN LINE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2785
Practice Address - Country:US
Practice Address - Phone:585-697-1557
Practice Address - Fax:585-697-5692
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011358-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist