Individual
RICHARD SCOTT RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18 JAYSON AVE, GREAT NECK, NY 11021-4238
(516) 773-8002
(516) 773-8002
Mailing address
18 JAYSON AVE, GREAT NECK, NY 11021-4238
(516) 773-8002
(516) 773-8002
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
172558
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01586552
—
NY
01
—
0F718
EMPIRE BLUE SHIELD
NY
01
—
10811759
CAQH
NY
Enumeration date
08/01/2006
Last updated
05/15/2026
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