Individual
MRS. BRIANNA L RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065
(215) 498-9312
Mailing address
47 RHODA AVE, NUTLEY, NJ 07110-1415
(215) 498-9312
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F341375
NY
Other
Enumeration date
05/04/2017
Last updated
05/04/2017
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