Individual
CHRISTINE MILLER-DELLO RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 LEEWATER AVE, MASSAPEQUA, NY 11758-8316
(516) 203-5669
Mailing address
PO BOX 421, MASSAPEQUA, NY 11758-0421
(516) 203-5669
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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