Individual
HEATHER RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
703 MAIN ST, PATERSON, NJ 07503-2621
(973) 754-2526
(973) 754-3792
Mailing address
202 LEXINGTON AVE, MAPLEWOOD, NJ 07040-3511
(973) 945-4029
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
918318
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2612526
UNITEDHEALTHCARE
—
01
—
7654551
AETNA
—
01
—
P3664391
OXFORD HEALTH PLANS
—
01
—
P3664398
OXFORD HEALTH PLANS
—
Enumeration date
10/18/2006
Last updated
07/08/2007
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