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Individual

ELSA RUSSOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
506 6TH STREET, BROOKLYN, NY 11215
(718) 780-3775
(718) 780-3774
Mailing address
506 6TH STREET, BROOKLYN, NY 11215
(718) 780-3775
(718) 780-3774

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
270589-1
NY
2084P0800X
Psychiatry Physician
CT52443
CT

Other

Enumeration date
07/01/2013
Last updated
05/17/2024
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