Individual
RUSSELL FERSTANDIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
25MA03504800
Contact information
Practice address
74 BRICK BLVD, SUITE 117, BLDG 4, BRICK, NJ 08723-7984
(732) 920-9050
(732) 920-9051
Mailing address
74 BRICK BLVD, SUITE 117, BLDG 4, BRICK, NJ 08723-7984
(732) 920-9050
(732) 920-9051
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA03504800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA03504800
MD LICENSE
NJ
Enumeration date
10/04/2006
Last updated
07/08/2007
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