Doctor Name: | DR. JARED WYDYSH |
NPI Number: | 1043690589 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T. |
License Number: | 037923 |
Business Practice Address: | 1200 Driving Park Ave Newark, NY - 145131090 |
Business Phone Number: | 3157498037 |
Business Fax Number: | |
Mailing Address: | 215 Alpine Knl, FAIRPORT |
State: | NY |
Postal Code: | 144501767 |
Phone Number: | 3157498037 |
Fax Number: | |
NPI Enumeration Date: | 05/30/2015 |
NPI Last Update Date: | 05/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 037923 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |