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Organization
RUSSO THERAPEUTICS, LLC
Active
Organization
RUSSO THERAPEUTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEATA D. RUSSO M.ED OTR/L, CHT (OWNER/OTR/L, CHT)
(860) 969-0207
Entity
Organization
Contact information
Practice address
561 KING STREET, SOUTH WINDSOR, CT 06074
(860) 969-0207
(833) 491-0465
Mailing address
850 CLARK STREET # 1382, SOUTH WINDSOR, CT 06074
(860) 969-0207
(833) 491-0465
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
225XH1200X
Hand Occupational Therapist
—
NULL
225XH1200X
Hand Occupational Therapist
—
—
Other
Enumeration date
05/04/2020
Last updated
06/17/2020
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