Individual
ASHLEY RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-5220
(774) 441-6790
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
260236
MA
2086X0206X
Surgical Oncology Physician
Primary
1015639
MA
Other
Enumeration date
04/01/2014
Last updated
07/27/2023
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