Provider Demographics
NPI:1316222045
Name:RUSZKOWSKI, ADAM HENRY (PT, DPT, OCS, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:HENRY
Last Name:RUSZKOWSKI
Suffix:
Gender:M
Credentials:PT, DPT, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 MARKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13207-1105
Mailing Address - Country:US
Mailing Address - Phone:315-525-2209
Mailing Address - Fax:
Practice Address - Street 1:6499 E SENECA TPKE
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-2800
Practice Address - Country:US
Practice Address - Phone:315-932-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034340225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist