Provider Demographics
NPI:1669565859
Name:RUSCITTO, JEFFREY GUY (DC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:GUY
Last Name:RUSCITTO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 KEEPORT DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-3006
Mailing Address - Country:US
Mailing Address - Phone:412-655-8171
Mailing Address - Fax:412-655-7232
Practice Address - Street 1:5400 KEEPORT DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-3006
Practice Address - Country:US
Practice Address - Phone:412-655-8171
Practice Address - Fax:412-655-7232
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005301L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
409534OtherHEALTH AMERICA
RU739138OtherBLUE CROSS/BLUESHIELD
251741468OtherDEVON
650526OtherACN GROUP
310901OtherUPMC
11026326OtherCAQH
PA01882363Medicaid
251741468OtherUNITED HEALTHCARE
409534OtherHEALTH ASSURANCE
1020542OtherAMERICAN SPECIALTY HEALTH
1605006001OtherCIGNA
409534OtherHEALTH AMERICA