Individual
MRS. ELLEN RUSYNIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2130 WEBBER RD, NEW WOODSTOCK, NY 13122-9729
(315) 662-3000
Mailing address
7349 FAIR HAVEN RD, HOMER, NY 13077-8710
(315) 399-9399
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
006378-1
NY
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
006378-1
NY
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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