Individual
DR. SANDRA ANN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
990 STEWART AVE, GARDEN CITY, NY 11530-4822
(516) 222-2022
(516) 222-8475
Mailing address
990 STEWART AVE, GARDEN CITY, NY 11530-4822
(516) 222-2022
(516) 222-8475
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
203514-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01665296
—
NY
Enumeration date
05/26/2006
Last updated
08/29/2013
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