Individual
DR. JOSEPH LOUIS RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHIROPRACTOR
Contact information
Practice address
500 PARK BLVD, MASSAPEQUA PARK, NY 11762-2742
(516) 798-8363
(516) 798-8586
Mailing address
500 PARK BLVD, MASSAPEQUA PARK, NY 11762-3042
(516) 798-8363
(516) 798-8586
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
X00003447
NY
Other
Enumeration date
11/17/2005
Last updated
10/10/2012
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