Individual
MS. MEGAN PATRICIA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
111 E 210TH ST, CRITICAL CARE MEDICINE OFFICE, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
3011 ZULETTE AVE, BRONX, NY 10461-5619
(914) 309-4266
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
016260
NY
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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