Individual
DR. EILEEN M. RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
303 5TH AVE, STE. 1103, NEW YORK, NY 10016-6601
(212) 714-5003
Mailing address
303 5TH AVE, STE. 1103, NEW YORK, NY 10016-6601
(212) 714-5003
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
014384
NY
103TC0700X
Clinical Psychologist
35SJ00459700
NJ
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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