Provider Demographics
NPI:1215152657
Name:KORDYLEWSKI, ROBERT (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:KORDYLEWSKI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 HUTH RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1751
Mailing Address - Country:US
Mailing Address - Phone:716-648-2450
Mailing Address - Fax:
Practice Address - Street 1:4650 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1939
Practice Address - Country:US
Practice Address - Phone:716-648-2450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023442-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist