Provider Demographics
NPI:1568649440
Name:SALVATORE J GALLUZZO DPM
Entity Type:Organization
Organization Name:SALVATORE J GALLUZZO DPM
Other - Org Name:ADIRONDACK FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GALLUZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:518-383-0302
Mailing Address - Street 1:950 ROUTE 146
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065
Mailing Address - Country:US
Mailing Address - Phone:518-383-0302
Mailing Address - Fax:518-373-2298
Practice Address - Street 1:950 ROUTE 146
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065
Practice Address - Country:US
Practice Address - Phone:518-383-0302
Practice Address - Fax:518-373-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0040891213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01520763Medicaid
56552AMedicare PIN
NY01520763Medicaid
1725380001Medicare NSC