Individual
BRANDON TYTKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT DPT
Contact information
Practice address
5959 BIG TREE RD STE 108, ORCHARD PARK, NY 14127-2291
(716) 204-3200
(716) 204-4337
Mailing address
BOX 8000, DEPARTMENT 314, BUFFALO, NY 14267-0002
(716) 213-0772
(716) 324-5004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
042444
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05710334
—
NY
Enumeration date
06/09/2017
Last updated
05/06/2022
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