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Organization
OPTIMAL PROFESSIONAL HEALTH SERVICES PC
Active
Organization
OPTIMAL PROFESSIONAL HEALTH SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH A RUSSO MD (OWNER)
(617) 364-1440
Entity
Organization
Contact information
Practice address
1418 PROVIDENCE HWY, SUITE N, NORWOOD, MA 02062-4655
(617) 964-1440
(617) 964-7833
Mailing address
944 WASHINGTON ST, SUITE ONE, SOUTH EASTON, MA 02375-1177
(508) 238-8646
(508) 230-9772
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110109264A
—
MA
Enumeration date
12/22/2015
Last updated
05/11/2016
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