Individual
JOHN NEIL RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 VASSAR DR NE, ALBUQUERQUE, NM 87106-2725
(505) 248-4012
Mailing address
13400 LOMAS BLVD NE, APT. E223, ALBUQUERQUE, NM 87112-6291
(505) 974-2440
(505) 248-7779
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
93-141
NM
Other
Enumeration date
12/14/2006
Last updated
01/20/2012
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