Basic Information
| Provider Information | |||||||||
| NPI: | 1588291249 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | METZGER-ORYNAWKA | ||||||||
| FirstName: | LAUREN | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6421 CLINTON ST | ||||||||
| Address2: | |||||||||
| City: | ELMA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140599493 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163521546 | ||||||||
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| Practice Location | |||||||||
| Address1: | 60 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HAMBURG | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140754905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166491618 | ||||||||
| FaxNumber: | 7166490916 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2020 | ||||||||
| LastUpdateDate: | 03/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 045593 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 06048131 | 05 | NY | MEDICAID |