Individual
JENNIFER RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
166 CENTRAL ST, LOWELL, MA 01852
(978) 513-7300
(781) 268-5070
Mailing address
240 MAIN ST, GROTON, MA 01450-1236
(978) 448-4300
(978) 448-4040
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
261536
MA
Other
Enumeration date
04/22/2012
Last updated
10/01/2024
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