Provider Demographics
NPI:1972761468
Name:RUTKOSKI, JOHN DANIEL (MD, FACS, FASMBS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DANIEL
Last Name:RUTKOSKI
Suffix:
Gender:M
Credentials:MD, FACS, FASMBS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2625 HARLEM RD STE 240
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4031
Mailing Address - Country:US
Mailing Address - Phone:716-893-0333
Mailing Address - Fax:716-893-3038
Practice Address - Street 1:2625 HARLEM RD STE 240
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4031
Practice Address - Country:US
Practice Address - Phone:716-893-0333
Practice Address - Fax:716-893-3038
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY277897208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery