Provider Demographics
NPI:1437908530
Name:RUSHTON, JOHN JOSEPH JR (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:RUSHTON
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 AMHERST VILLA RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1400
Mailing Address - Country:US
Mailing Address - Phone:800-960-1080
Mailing Address - Fax:
Practice Address - Street 1:55 AMHERST VILLA RD STE 2
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225-1400
Practice Address - Country:US
Practice Address - Phone:800-960-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRUSHJ2207K00000X, 207SG0203X, 207SG0207X, 207ZM0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular GeneticsGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207SG0207XAllopathic & Osteopathic PhysiciansMedical GeneticsMedical Biochemical Genetics
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology