Individual
DR. MICHAEL SCOTT RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
100 N CENTRE AVE, SUITE 202, ROCKVILLE CENTRE, NY 11570-3937
(516) 763-2600
(516) 763-4218
Mailing address
100 N CENTRE AVE, SUITE 202, ROCKVILLE CENTRE, NY 11570-3937
(516) 763-2600
(516) 763-4218
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X006933
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002357
SELECT PRO ID#
NY
01
—
1295243
UNITED HEALTHCARE ID#
NY
01
—
1C9303
HEALTHNET ID#
NY
01
—
322612
ACN GROUP ID#
NY
01
—
5303872
GHI / ALIGNIS ID#
NY
01
—
5597187
AETNA ID #
NY
01
—
63503
VYTRA ID#
NY
01
—
CO6933-8
NYS WORK COMP #
NY
01
—
NY06933
LANDMARK HC ID#
NY
01
—
P62591639
MULTIPLAN ID#
NY
01
—
P744425
OXFORD ID #
NY
Enumeration date
06/14/2006
Last updated
07/08/2010
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