Provider Demographics
NPI:1679545057
Name:PYRDA, PAWEL J (DC)
Entity type:Individual
Prefix:DR
First Name:PAWEL
Middle Name:J
Last Name:PYRDA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:13417-1449
Mailing Address - Country:US
Mailing Address - Phone:315-736-2793
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:315-733-4325
Practice Address - Fax:315-736-2990
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor