Individual
DANIEL JOSEPH RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14445 87TH AVE, BRIARWOOD, NY 11435-3109
(718) 480-4024
(718) 480-4028
Mailing address
68 THE DELL, SEARINGTOWN, NY 11507
(516) 621-4987
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
164191
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01937044
—
NY
Enumeration date
07/28/2006
Last updated
01/28/2010
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