Organization
RUSS L'HOMMEDIEU PT, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSS A L'HOMMEDIEU PTMA (OWNER)
(631) 477-6035
Entity
Organization
Contact information
Practice address
633 E MAIN ST, SUITE 3, RIVERHEAD, NY 11901-7013
(631) 477-6035
(631) 614-4291
Mailing address
985 CARRINGTON RD, CUTCHOGUE, NY 11935-1624
(631) 765-8069
(631) 614-4291
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
011600
NY
2251G0304X
Geriatric Physical Therapist
011600
NY
2251H1300X
Human Factors Physical Therapist
011600
NY
2251P0200X
Pediatric Physical Therapist
011600
NY
2251S0007X
Sports Physical Therapist
011600
NY
2251X0800X
Orthopedic Physical Therapist
Primary
011600
NY
Other
Enumeration date
10/24/2006
Last updated
09/11/2025
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