Provider Demographics
NPI:1225266299
Name:KALCZYNSKI, KARI ANN (LMT)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:ANN
Last Name:KALCZYNSKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 BROADWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14004-9737
Mailing Address - Country:US
Mailing Address - Phone:716-777-0616
Mailing Address - Fax:716-632-7464
Practice Address - Street 1:12001 BROADWAY
Practice Address - Street 2:SUITE B
Practice Address - City:ALDEN
Practice Address - State:NY
Practice Address - Zip Code:14004-9737
Practice Address - Country:US
Practice Address - Phone:716-777-0616
Practice Address - Fax:716-632-7464
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016772225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist