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Organization

MICHAEL RUSS, MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL LOYD RUSS MD (PRESIDENT)
(516) 255-0620
Entity
Organization

Contact information

Practice address
70 GLEN ST, SUITE 380, GLEN COVE, NY 11542-2855
(516) 759-2424
(516) 759-6627
Mailing address
100 DALY BLVD, #2505, OCEANSIDE, NY 11572-6000
(516) 255-0620

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
188435
NY

Other

Enumeration date
07/12/2006
Last updated
08/22/2020
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