Provider Demographics
NPI:1649425547
Name:SCHOSEK, KENNETH J (LMT)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:J
Last Name:SCHOSEK
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1122
Mailing Address - Country:US
Mailing Address - Phone:716-622-5642
Mailing Address - Fax:
Practice Address - Street 1:217 ROBIN RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1122
Practice Address - Country:US
Practice Address - Phone:716-622-5642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021611-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist