Individual
MS. ANN M RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
380 WASHINGTON AVE, ROOSEVELT, NY 11575-1845
(516) 378-2000
Mailing address
10 EVA PATH, COMMACK, NY 11725-5202
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0133141
NY
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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