Individual
DR. GEORGE A RUSSO II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1901 1ST AVE DEPT OF, NEW YORK, NY 10029-7491
(212) 423-6271
Mailing address
1901 1ST AVE DEPT OF, NEW YORK, NY 10029-7491
(212) 423-6271
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
317767
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2019
Last updated
08/02/2022
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