Provider Demographics
NPI:1942579867
Name:BRYDALSKI, PATRICIA JO (MSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JO
Last Name:BRYDALSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-1503
Mailing Address - Country:US
Mailing Address - Phone:716-882-2127
Mailing Address - Fax:
Practice Address - Street 1:1300 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1503
Practice Address - Country:US
Practice Address - Phone:716-882-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker