Provider Demographics
NPI:1275023681
Name:KATIE DANIELS BUYNISKI DPT, P.C.
Entity Type:Organization
Organization Name:KATIE DANIELS BUYNISKI DPT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:DANIELS
Authorized Official - Last Name:BUYNISKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-629-4076
Mailing Address - Street 1:1440 FISHER ST
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2607
Mailing Address - Country:US
Mailing Address - Phone:219-629-4076
Mailing Address - Fax:
Practice Address - Street 1:610 RIDGE RD
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1610
Practice Address - Country:US
Practice Address - Phone:219-595-7473
Practice Address - Fax:219-444-4518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty