Organization
JOSEPH A RUSSO OD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH A RUSSO OD (OWNER OPTOMETRIST)
(207) 383-3456
Entity
Organization
Contact information
Practice address
364 MAINE MALL RD STE F128, SOUTH PORTLAND, ME 04106-3206
(207) 383-3456
(207) 383-3409
Mailing address
364 MAINE MALL RD STE F128, SOUTH PORTLAND, ME 04106-3206
(207) 383-3456
(207) 383-3409
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
06/29/2022
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