Individual
ELAINA J LARUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
470 E FORDHAM RD, BRONX, NY 10458-5108
(718) 960-3801
Mailing address
470 E FORDHAM RD, BRONX, NY 10458-5108
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
277587
NY
Other
Enumeration date
07/20/2010
Last updated
09/25/2015
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