Individual
MR. RUSSELL KOUTROUBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
220 FORT SALONGA ROAD, NORTHPORT, NY 11768
(631) 757-2688
Mailing address
22 NEVINWOOD PLACE, HUNTINGTON STATION, NY 11746
(631) 385-8314
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
2125
NY
172M00000X
Mechanotherapist
Primary
8054
NY
Other
Enumeration date
04/23/2007
Last updated
09/11/2025
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