Individual
KERRY S RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 HOWARD AVE, YALE PHYSICIANS' BUILDING, 2ND FLOOR, NEW HAVEN, CT 06519-1369
(203) 785-4114
(203) 737-2437
Mailing address
800 HOWARD AVE, YALE PHYSICIANS' BUILDING, 2ND FLOOR, NEW HAVEN, CT 06519-1369
(203) 785-4114
(203) 737-2437
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
038909
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001389099
—
CT
Enumeration date
10/11/2005
Last updated
03/31/2011
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