Individual
DR. THOMAS ALAN RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., C.M.
Contact information
Practice address
3495 BAILEY AVE, BUFFALO, NY 14215-1129
(716) 834-9200
Mailing address
3435 MAIN ST, BRB, ROOM 141, BUFFALO, NY 14214-3001
(716) 829-2674
(716) 829-3889
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
198067
NY
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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