Provider Demographics
NPI:1356782171
Name:BYRWA, KATHERINE ELYSE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ELYSE
Last Name:BYRWA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:ELYSE
Other - Last Name:LEBLANC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:164 DONCASTER ROAD
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217
Mailing Address - Country:US
Mailing Address - Phone:716-874-6175
Mailing Address - Fax:
Practice Address - Street 1:3767 DELAWARE AVENUE
Practice Address - Street 2:ASSOCIATED PHYSICAL & OCCUPATIONAL THERAPISTS
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217
Practice Address - Country:US
Practice Address - Phone:716-874-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034249-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist