Provider Demographics
NPI:1164667705
Name:SKYE, MARIANNE (PTA, RYT-200)
Entity Type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:
Last Name:SKYE
Suffix:
Gender:F
Credentials:PTA, RYT-200
Other - Prefix:MISS
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:TOMASZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:200 E MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2200
Mailing Address - Country:US
Mailing Address - Phone:585-813-8623
Mailing Address - Fax:
Practice Address - Street 1:200 E MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2200
Practice Address - Country:US
Practice Address - Phone:585-813-8623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004537-1225200000X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant