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MR. ALEXANDER RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
64 INDIAN HEAD RD, KINGS PARK, NY 11754-3703
(631) 663-3800
Mailing address
18 GRAND ST, SMITHTOWN, NY 11787-1207
(631) 807-2666

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
067695
NY

Other

Enumeration date
02/12/2021
Last updated
02/12/2021
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