Individual
ANMARIE J RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
88 ANSEL HALLET RD, WEST YARMOUTH, MA 02673-2556
(508) 771-4848
(508) 775-4103
Mailing address
50 STANIFORD ST, SUITE 600, BOSTON, MA 02114-2517
(617) 367-4800
(617) 589-3905
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3897
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003897
TUFT HEALTH PLAN
—
05
—
0369721
—
MA
01
—
152022
HARVARD PILGRAM HLTH CARE
—
Enumeration date
05/10/2006
Last updated
11/21/2007
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