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Individual
DR. PHILLIP J KACZMAREK
Active
Individual
DR. PHILLIP J KACZMAREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C., P.T.
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
X010491-1
NY
225100000X
Physical Therapist
Primary
018590-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025998702
UNIVERA, PT
NY
01
—
006268201
COMMUNITY BLUE, PT
NY
01
—
9311595
INDEPENDENT HEALTH, PT
NY
Enumeration date
10/25/2006
Last updated
09/30/2014
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