Individual
MR. ROBERT EDWARD RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 RAILROAD STREET, ESSEX JUNCTION, VT 05453
(802) 879-4515
(802) 879-4515
Mailing address
PO BOX 35, 18 RAILROAD STREET, ESSEX JUNCTION, VT 05453
(802) 879-4515
(802) 879-4515
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
14
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006615
—
VT
Enumeration date
10/02/2006
Last updated
07/08/2007
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