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Individual

GREGORY K RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2909 MAIN ST, ROBERT D. RUSSO, M.D. & ASSOCIATES RADIOLOGY, P.C., STRATFORD, CT 06614-4960
(203) 683-4570
(203) 926-1415
Mailing address
PO BOX 6128, ROBERT D. RUSSO, M.D. & ASSOCIATES RADIOLOGY, P.C., BRIDGEPORT, CT 06606-0128
(203) 683-4570
(203) 926-1415

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
043621
CT
2085R0202X
Diagnostic Radiology Physician
112031
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001436212
CT
01
010043621
ANTHEM BC/BS
CT
Enumeration date
07/18/2006
Last updated
04/30/2026
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