Provider Demographics
NPI:1811097090
Name:GALUSHA, TODD MATTHEW (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:MATTHEW
Last Name:GALUSHA
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 1:185 SAINT PAUL ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14604-1125
Mailing Address - Country:US
Mailing Address - Phone:585-454-1720
Mailing Address - Fax:585-672-5675
Practice Address - Street 1:185 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1125
Practice Address - Country:US
Practice Address - Phone:585-454-1720
Practice Address - Fax:585-672-5675
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC8461Medicare ID - Type UnspecifiedMEDICARE ID NUMBER