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Individual

HEIDI R RUSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
935 NORTHERN BLVD, SUITE 300, GREAT NECK, NY 11021-5309
(516) 466-5437
(516) 466-9081
Mailing address
935 NORTHERN BLVD, SUITE 300, GREAT NECK, NY 11021-5309
(516) 466-5437
(516) 466-9081

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
183625
NY

Other

Enumeration date
11/07/2006
Last updated
07/08/2007
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