Individual
RICHARD JAY RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
30 MERRITT AVE, MASSAPEQUA, NY 11758-7931
(516) 795-8994
Mailing address
30 MERRITT AVE, MASSAPEQUA, NY 11758-7931
(516) 795-8994
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
2817
NY
225XH1200X
Hand Occupational Therapist
2817
NY
225XH1300X
Human Factors Occupational Therapist
2817
NY
225XN1300X
Neurorehabilitation Occupational Therapist
2817
NY
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
2817
NY
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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