Provider Demographics
NPI:1265431894
Name:RUFA, ADAM P (PT)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:P
Last Name:RUFA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5496 E TAFT RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-3784
Mailing Address - Country:US
Mailing Address - Phone:315-451-6541
Mailing Address - Fax:315-451-7059
Practice Address - Street 1:5496 E TAFT RD
Practice Address - Street 2:SUITE 2
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-3784
Practice Address - Country:US
Practice Address - Phone:315-451-6541
Practice Address - Fax:315-451-7059
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2010-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024346-2225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA6543Medicare ID - Type Unspecified
P69574Medicare UPIN