Individual
MS. DONNA A RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5 E 98TH ST, BOX1188, NEW YORK, NY 10029-6501
(121) 224-1810
Mailing address
5 E 98TH ST, BOX1188, NEW YORK, NY 10029-6501
(121) 224-1810
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
008624-1
NY
Other
Enumeration date
02/16/2010
Last updated
02/16/2010
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