Individual
DR. MICHAEL THOMAS RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
15 COMMERCE RD, 3RD FLOOR, STAMFORD, CT 06902-4549
(203) 324-9100
(203) 324-9400
Mailing address
15 COMMERCE RD, 3RD FLOOR, STAMFORD, CT 06902-4549
(203) 324-9100
(203) 324-9400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
029640
NY
Other
Enumeration date
10/17/2007
Last updated
01/06/2014
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