Provider Demographics
NPI:1073841243
Name:DR. JOSEPH P. RUSKIEWICZ
Entity Type:Organization
Organization Name:DR. JOSEPH P. RUSKIEWICZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER/CHIEF OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:RUSKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-326-2754
Mailing Address - Street 1:1100 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-9216
Mailing Address - Country:US
Mailing Address - Phone:610-326-2754
Mailing Address - Fax:610-272-1456
Practice Address - Street 1:1100 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-9216
Practice Address - Country:US
Practice Address - Phone:610-326-2754
Practice Address - Fax:610-272-1456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-OOO164152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty