Provider Demographics
NPI:1588403232
Name:RUSCO, MEGHAN C
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:C
Last Name:RUSCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 W GENESEE STREET RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-9458
Mailing Address - Country:US
Mailing Address - Phone:315-406-9247
Mailing Address - Fax:
Practice Address - Street 1:2119 W GENESEE STREET RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-9458
Practice Address - Country:US
Practice Address - Phone:315-406-9247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator