Individual
DR. PAUL EDWARD RUSSO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-3469
Mailing address
24 OLD FARMS E, MIDDLETOWN, CT 06457-7534
(860) 343-0366
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
041302
CT
Other
Enumeration date
01/14/2007
Last updated
07/08/2007
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