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NPI Code Detail

MEDICARE: JOSEPH E CHRUSCICKI M.D.

MEDICARE: JOSEPH E CHRUSCICKI M.D.
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
12084P0800XPsychiatry Physician215576NY
22084P0804XChild & Adolescent Psychiatry Physician215576NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110989059OTHERNYCAQH
200027056901OTHERNYUNIVERA
31512813OTHERNYINDEPENDENT HEALTH
4000528054001OTHERNYHEALTH INTEGRATED

General Provider Information

NPI Number : 1609879410
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH E CHRUSCICKI M.D.
Provider Business Mailing Address
First Line : 141 SULLYS TRL
Second Line : STE 5B
City : PITTSFORD
State : NY
Zip : 14534-4563
Country : US
Telephone Number : 585-368-6550
Fax Number : 585-368-6540
Provider Business Practice Location Address
First Line : 141 SULLYS TRL
Second Line : STE 5B
City : PITTSFORD
State : NY
Zip : 14534-4563
Country : US
Telephone Number : 585-368-6550
Fax Number : 585-368-6540
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 03/19/2020

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Directions to “ JOSEPH E CHRUSCICKI M.D.” Practice Location

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