Provider Demographics
NPI:1952566754
Name:NANDZIK-PYRDA, ANNE-MARIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:ANNE-MARIE
Middle Name:
Last Name:NANDZIK-PYRDA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-1022
Mailing Address - Country:US
Mailing Address - Phone:315-733-4581
Mailing Address - Fax:315-736-2990
Practice Address - Street 1:49 MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:NY
Practice Address - Zip Code:13492-1022
Practice Address - Country:US
Practice Address - Phone:315-733-4581
Practice Address - Fax:315-736-2990
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012682172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist