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Individual

JOSEPH E CHRUSCICKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
141 SULLYS TRL, STE 5B, PITTSFORD, NY 14534-4563
(585) 368-6550
(585) 368-6540
Mailing address
141 SULLYS TRL, STE 5B, PITTSFORD, NY 14534-4563
(585) 368-6550
(585) 368-6540

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
215576
NY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
215576
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00027056901
UNIVERA
NY
01
000528054001
HEALTH INTEGRATED
NY
01
10989059
CAQH
NY
01
1512813
INDEPENDENT HEALTH
NY
Enumeration date
05/24/2005
Last updated
03/19/2020
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