Individual
MISS DOROTHY MICHELE RUSSO I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
773-775 9TH AVENUE, NEW YORK, NY 10019
(212) 586-1550
Mailing address
3035 WAVERLY AVE, OCEANSIDE, NY 11572-2720
(516) 581-8919
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
511914
NY
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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