Individual
DR. LEWIS M. RUSSAKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 N BROADWAY, SLEEPY HOLLOW, SLEEPY HOLLOW, NY 10591-1020
(914) 366-3604
(914) 366-1302
Mailing address
701 N BROADWAY, SLEEPY HOLLOW, SLEEPY HOLLOW, NY 10591-1020
(914) 366-3604
(914) 366-1302
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
113198
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01590647
—
NY
Enumeration date
10/03/2006
Last updated
01/20/2015
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