Provider Demographics
NPI:1770789190
Name:KUBIAK-RIZZONE, KATHRYN LIN (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LIN
Last Name:KUBIAK-RIZZONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 WARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1156
Mailing Address - Country:US
Mailing Address - Phone:919-636-0308
Mailing Address - Fax:
Practice Address - Street 1:52 WARRINGTON DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-1156
Practice Address - Country:US
Practice Address - Phone:919-636-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2015-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8632225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist