Provider Demographics
NPI:1982881546
Name:RUSZALA, KAREN L (LMT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:RUSZALA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ARCADE
Mailing Address - State:NY
Mailing Address - Zip Code:14009-1615
Mailing Address - Country:US
Mailing Address - Phone:585-322-3916
Mailing Address - Fax:
Practice Address - Street 1:259 MAIN ST
Practice Address - Street 2:
Practice Address - City:ARCADE
Practice Address - State:NY
Practice Address - Zip Code:14009-1212
Practice Address - Country:US
Practice Address - Phone:585-322-3916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020783-1172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist