Provider Demographics
NPI:1508436833
Name:BEZEK, KRISTIN (DC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:BEZEK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 FIVE MILE LINE RD STE E
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-2209
Mailing Address - Country:US
Mailing Address - Phone:585-469-1571
Mailing Address - Fax:585-203-1741
Practice Address - Street 1:2132 FIVE MILE LINE RD STE E
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2209
Practice Address - Country:US
Practice Address - Phone:585-469-1571
Practice Address - Fax:585-203-1741
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor