National Provider Identifier
Kerryellen Lakin Syracuse, PT, DPT
Kerryellen Lakin Syracuse, PT, DPT is listed in the NPPES registry with a primary specialty of Physical Therapist in Cheektowaga, NY and a listed phone number of (716) 505-5630.
Profile Overview
- NPI
- 1790220093
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- December 23, 2016
- Last Updated
- March 11, 2020
Practice Location
- 7 Community Dr
- Cheektowaga, NY 14225-2523
Phone: (716) 505-5630
Mailing Address
- 3820 S Jones Blvd
- Las Vegas, NV 89103-2228
Specialties
- Physical Therapist (225100000X)
- Physical Therapist (225100000X)
Full Record
- NPI
- 1790220093
- Entity Type
- Individual
- Last Name
- Syracuse
- First Name
- Kerryellen
- Middle Name
- Lakin
- Credential
- PT, DPT
- Provider Other Last Name
- Willard
- Provider Other First Name
- Kerryellen
- Provider Other Middle Name
- Lakin
- Provider Other Credential Text
- PT, DPT
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 3820 S Jones Blvd
- Mailing City
- Las Vegas
- Mailing State
- NV
- Mailing ZIP Code
- 89103-2228
- Mailing Country
- US
- Practice Street Address
- 7 Community Dr
- Practice City
- Cheektowaga
- Practice State
- NY
- Practice ZIP Code
- 14225-2523
- Practice Country
- US
- Practice Phone
- (716) 505-5630
- Practice Fax
- (716) 892-1936
- Enumeration Date
- December 23, 2016
- Last Updated
- March 11, 2020
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 4
- 193200000X Multi-Specialty Group
- Certification Date
- March 11, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X), Physical Therapist (225100000X)