Individual
RAYMOND RICHARD RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 HOWARD AVE, YALE PHYSICIANS BUILDING, NEW HAVEN, CT 06519-1369
(203) 785-2140
(203) 785-6414
Mailing address
300 GEORGE ST, 6TH FLOOR, NEW HAVEN, CT 06511-6624
(203) 785-7998
(203) 785-6414
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
038910
CT
207UN0901X
Nuclear Cardiology Physician
038910
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001389106
—
CT
Enumeration date
11/21/2005
Last updated
02/20/2013
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