Individual
BRITTANY RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 CORPORATE BLVD S, YONKERS, NY 10701-6862
(914) 294-6152
Mailing address
300 CORPORATE BLVD S, YONKERS, NY 10701-6862
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2503096
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2503096
NYDOE
NY
Enumeration date
05/25/2017
Last updated
05/25/2017
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