=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568649440
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SALVATORE J GALLUZZO DPM
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/23/2008
-----------------------------------------------------
Last Update Date | 06/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 950 ROUTE 146
-----------------------------------------------------
City | CLIFTON PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-383-0302
-----------------------------------------------------
Fax | 518-373-2298
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 950 ROUTE 146
-----------------------------------------------------
City | CLIFTON PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-383-0302
-----------------------------------------------------
Fax | 518-373-2298
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE PROPRIETOR
-----------------------------------------------------
Name | DR. SALVATORE JOHN GALLUZZO
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 518-383-0302
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | N0040891
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------