MEDICARE: DR. MICHAEL PATRICK HUSON PT, DPT, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	023660-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6698328	OTHER	NY	GHI
2	P010023660	OTHER	NY	BLUE CROSS BLUE SHIELD
3	7211048	OTHER	NY	AETNA
4	FA1238	OTHER	NY	PREFERRED CARE
5	470614	OTHER	NY	TUFTS
6	605817000	OTHER	NY	ACS
7	837358	OTHER	NY	MPN

General Provider Information

NPI Number	:	1417959461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL PATRICK HUSON PT, DPT, MS

Provider Business Mailing Address
First Line	:	675 W WASHINGTON ST
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456-2119
Country	:	US
Telephone Number	:	315-781-1144
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 W WASHINGTON ST
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456-2119
Country	:	US
Telephone Number	:	315-781-1144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	02/10/2010

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