Individual
RUSSELL J CREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
622 W 168TH ST, PH 4-124, NEW YORK, NY 10032-3720
(212) 305-3273
(212) 305-6692
Mailing address
622 W 168TH ST, PH 4-124, NEW YORK, NY 10032-3720
(212) 305-3273
(212) 305-6692
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
219461
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
219461
STATE LICENSE
NY
Enumeration date
10/19/2006
Last updated
07/08/2007
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