Individual
CAROL DOODIAN-RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1477 HYLAN BLVD, STATEN ISLAND, NY 10305-1906
(718) 979-6900
(718) 979-6940
Mailing address
719 BEMENT AVE, STATEN ISLAND, NY 10310-3101
(917) 699-4362
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
344681
NY
Other
Enumeration date
02/07/2014
Last updated
02/10/2014
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