Individual
RUSSELL KEITH PORTENOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MJHS HOSPICE AND PALLIATIVE CARE, 39 BROADWAY #R FL, NEW YORK, NY 10006
(212) 649-5560
(212) 649-5544
Mailing address
MJHS HOSPICE AND PALLIATIVE CARE, 39 BROADWAY #R FL, NEW YORK, NY 10006
(212) 649-5560
(212) 649-5544
Taxonomy
Speciality
Code
Description
License number
State
2084H0002X
Hospice and Palliative Medicine (Psychiatry & Neurology) Physician
Primary
146475
NY
2084N0400X
Neurology Physician
146475
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00906634
—
NY
Enumeration date
11/08/2005
Last updated
05/06/2021
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