Provider Demographics
NPI:1346964756
Name:LISZEWSKI, KYLE EDWARD (PSYD)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:EDWARD
Last Name:LISZEWSKI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BRYANT WOODS S
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3604
Mailing Address - Country:US
Mailing Address - Phone:716-689-3333
Mailing Address - Fax:716-689-9695
Practice Address - Street 1:85 BRYANT WOODS S
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-3604
Practice Address - Country:US
Practice Address - Phone:716-689-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026037103TC0700X
NY118136-01103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical