| Jack D Rush, MD | |
|
909 Strawberry Ln, Clayton, NY 13624-1409 | |
| (315) 686-2094 | |
| (315) 686-2821 |
| Full Name | Jack D Rush |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 909 Strawberry Ln, Clayton, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356399844 | NPI | - | NPPES |
| 00354316 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 153963 (New York) | Primary |
| Entity Name | Samaritan Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598713745 PECOS PAC ID: 8123914876 Enrollment ID: O20040227000525 |
| Mailing Address | Practice Location Address |
|---|---|
| Jack D Rush, MD 909 Strawberry Ln, Clayton, NY 13624-1409 Ph: (315) 686-2094 | Jack D Rush, MD 909 Strawberry Ln, Clayton, NY 13624-1409 Ph: (315) 686-2094 |
Dr. Aaron Dale Huizenga, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 909 Strawberry Ln, Clayton, NY 13624 Phone: 315-686-2094 Fax: 315-686-2821 | |
Galina Gindina, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 909 Strawberry Ln, Sfhc, Clayton, NY 13624 Phone: 315-686-2094 | |
Stephen Grybowski, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 909 Strawberry Ln, Clayton, NY 13624 Phone: 315-686-2094 Fax: 315-686-2821 |