# IDENTITY PHYSICAL THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Joseph Ruszkowski Physical Therapy PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265297642
- **Authorized official:** JOSEPH RUSZKOWSKI DPT (CEO)
- **Authorized official phone:** (973) 577-5921

## Contact information

- **Practice address:** 593 S LIVINGSTON AVENUE, LIVINGSTON, NJ 07039-0703
- **Practice address phone:** (973) 577-5921
- **Practice address fax:** (888) 686-2968
- **Mailing address:** 593 S LIVINGSTON AVENUE, LIVINGSTON, NJ 07039
- **Mailing address phone:** (973) 577-5921
- **Mailing address fax:** (888) 686-2968

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/15/2024
- **Last updated:** 02/15/2024