National Provider Identifier
Lara Kristine Herzog, PT, DPT
Lara Kristine Herzog, PT, DPT is listed in the NPPES registry with a primary specialty of Physical Therapist in East Aurora, NY and a listed phone number of (716) 714-9860.
Profile Overview
- NPI
- 1326445867
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- November 26, 2014
- Last Updated
- April 14, 2021
Practice Location
- 48 Douglas Ln
- East Aurora, NY 14052-2124
Phone: (716) 714-9860
Mailing Address
- Box 8000
- Dept 314
- Buffalo, NY 14267-0002
Specialties
- Physical Therapist (225100000X)
- Physical Therapist (225100000X)
Full Record
- NPI
- 1326445867
- Entity Type
- Individual
- Last Name
- Herzog
- First Name
- Lara
- Middle Name
- Kristine
- Credential
- PT, DPT
- Provider Other Last Name
- Spiegel
- Provider Other First Name
- Lara
- Provider Other Middle Name
- Kristine
- Provider Other Credential Text
- PT DPT
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- Box 8000
- Mailing Address Line 2
- Dept 314
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14267-0002
- Mailing Country
- US
- Mailing Phone
- (716) 213-0772
- Mailing Fax
- (716) 324-5004
- Practice Street Address
- 48 Douglas Ln
- Practice City
- East Aurora
- Practice State
- NY
- Practice ZIP Code
- 14052-2124
- Practice Country
- US
- Practice Phone
- (716) 714-9860
- Practice Fax
- (716) 714-9864
- Enumeration Date
- November 26, 2014
- Last Updated
- April 14, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- April 14, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X), Physical Therapist (225100000X)
- Other Identifiers
- 05899665 (NY)