Provider Demographics
NPI:1306488150
Name:MAKASZIW PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:MAKASZIW PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKASZIW
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:585-683-2515
Mailing Address - Street 1:16 JUDD LN
Mailing Address - Street 2:
Mailing Address - City:HILTON
Mailing Address - State:NY
Mailing Address - Zip Code:14468-9752
Mailing Address - Country:US
Mailing Address - Phone:585-683-2515
Mailing Address - Fax:
Practice Address - Street 1:1150 CROSSPOINTE LN STE 3
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2995
Practice Address - Country:US
Practice Address - Phone:585-872-9669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty