Provider Demographics
NPI:1437497427
Name:FIEDLER, KAYLEE I (DPT)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:I
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:I
Other - Last Name:KOWALCZYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:11831 RT 9W
Mailing Address - Street 2:
Mailing Address - City:WEST COXSACKIE
Mailing Address - State:NY
Mailing Address - Zip Code:12192-3605
Mailing Address - Country:US
Mailing Address - Phone:518-731-1157
Mailing Address - Fax:518-731-1158
Practice Address - Street 1:11831 RT 9W
Practice Address - Street 2:
Practice Address - City:WEST COXSACKIE
Practice Address - State:NY
Practice Address - Zip Code:12192-3605
Practice Address - Country:US
Practice Address - Phone:518-731-1157
Practice Address - Fax:518-731-1158
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist