Provider Demographics
NPI:1689553596
Name:DEMARCO, BRIANNA (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6665 HELTZ RD
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:NY
Mailing Address - Zip Code:14085-9659
Mailing Address - Country:US
Mailing Address - Phone:716-364-4493
Mailing Address - Fax:
Practice Address - Street 1:1086B UNION RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3449
Practice Address - Country:US
Practice Address - Phone:716-608-6730
Practice Address - Fax:716-608-6445
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054847-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist