Individual
THOMAS J RUSSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9920 4TH AVE, SUITE 109, BROOKLYN, NY 11209-8333
(718) 238-4305
Mailing address
9920 4TH AVE STE 301, BROOKLYN, NY 11209-8330
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
192288
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01822577
—
NY
Enumeration date
05/16/2006
Last updated
01/24/2019
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