Provider Demographics
NPI:1578610218
Name:KRZYZANOWICZ, RYAN (ATC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:KRZYZANOWICZ
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 KIMBALL TOWER
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-8028
Mailing Address - Country:US
Mailing Address - Phone:716-829-5439
Mailing Address - Fax:
Practice Address - Street 1:207 KIMBALL TOWER
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-8028
Practice Address - Country:US
Practice Address - Phone:168-295-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0107020232255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer