Individual
CHRISTOPHER PAUL RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS. ED., TVI
Contact information
Practice address
649 39TH ST, BROOKLYN, NY 11232-3101
(718) 851-3399
Mailing address
4100 43RD AVE APT DW, SUNNYSIDE, NY 11104-2766
(650) 722-2319
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1412542
NY
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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