Individual
DR. RUSSELL J CAVALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 S RIDGE ST, SUITE UL-1, RYE BROOK, NY 10573-2867
(914) 708-1111
Mailing address
90 S RIDGE ST, SUITE UL-1, RYE BROOK, NY 10573-2867
(914) 708-1111
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
038069
CT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
196211
NY
Other
Enumeration date
05/31/2005
Last updated
10/04/2011
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