Provider Demographics
NPI:1447260740
Name:HALUSKA, JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:HALUSKA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 N MAIN ST STE 130
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2939
Mailing Address - Country:US
Mailing Address - Phone:607-767-6893
Mailing Address - Fax:866-453-2143
Practice Address - Street 1:160 N MAIN ST STE 130
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2939
Practice Address - Country:US
Practice Address - Phone:607-767-6893
Practice Address - Fax:866-453-2143
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222016207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02365653Medicaid
NYDD3657Medicare ID - Type Unspecified
NYA17380Medicare UPIN