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Individual
ROCCO RUSSO
Active
Individual
ROCCO RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
035913
CT
207Q00000X
Family Medicine Physician
Primary
259143
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010035913CT
ANTHEM
CT
05
—
03421327
—
NY
05
—
1174664858
—
CT
01
—
2V9661
HEALTHNET
CT
Enumeration date
02/08/2007
Last updated
12/10/2018
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