Provider Demographics
NPI:1821766775
Name:PIZZEY, BRADLEY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:PIZZEY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 MILBURN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3423
Mailing Address - Country:US
Mailing Address - Phone:248-881-2085
Mailing Address - Fax:
Practice Address - Street 1:7670 OMNITECH PL
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9782
Practice Address - Country:US
Practice Address - Phone:585-602-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist