Individual
MRS. SARRA RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2876 MAIN ST, STRATFORD, CT 06614-4984
(203) 219-3929
Mailing address
2601 OCEAN PKWY, BROOKLYN, NY 11235-7745
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
016098
NY
Other
Enumeration date
10/16/2012
Last updated
07/30/2021
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