# MICHAEL RUSS, MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437184959
- **Authorized official:** DR. MICHAEL LOYD RUSS MD (PRESIDENT)
- **Authorized official phone:** (516) 255-0620

## Contact information

- **Practice address:** 70 GLEN ST, SUITE 380, GLEN COVE, NY 11542-2855
- **Practice address phone:** (516) 759-2424
- **Practice address fax:** (516) 759-6627
- **Mailing address:** 100 DALY BLVD, \#2505, OCEANSIDE, NY 11572-6000
- **Mailing address phone:** (516) 255-0620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 188435 | NY | Yes |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 08/22/2020