Provider Demographics
NPI:1588762843
Name:MACALUSO, JAMES MICHAEL (PT MA OCS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MICHAEL
Last Name:MACALUSO
Suffix:
Gender:M
Credentials:PT MA OCS
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Mailing Address - Street 1:397 WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596
Mailing Address - Country:US
Mailing Address - Phone:516-739-5503
Mailing Address - Fax:516-739-5565
Practice Address - Street 1:27003 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2517
Practice Address - Country:US
Practice Address - Phone:718-831-1900
Practice Address - Fax:718-831-9766
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
010473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04760HMedicare ID - Type Unspecified