Individual
COLETTE RUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2581 ATLANTIC AVE, BROOKLYN, NY 11207-2412
(718) 495-6700
(646) 988-2840
Mailing address
60 MADISON AVE, 5TH FL, NEW YORK, NY 10010-1600
(212) 545-2400
(646) 312-0481
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
340356
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00695941
—
NY
Enumeration date
02/05/2016
Last updated
04/01/2021
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