Individual
CYNTHIA RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
3 TEE CT, SOUTH SETAUKET, NY 11720-1016
(347) 242-9870
Mailing address
3 TEE CT, SOUTH SETAUKET, NY 11720-1016
(347) 242-9870
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
559771-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
559771-1
—
NY
Enumeration date
04/20/2009
Last updated
04/20/2009
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