Provider Demographics
NPI:1316491186
Name:GLADYSZ, STEPHEN VICTOR (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:VICTOR
Last Name:GLADYSZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 SNYDERWOODS CT
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2562
Mailing Address - Country:US
Mailing Address - Phone:716-316-5398
Mailing Address - Fax:
Practice Address - Street 1:767 MINERAL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1053
Practice Address - Country:US
Practice Address - Phone:716-316-5398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012745-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor