Individual
MR. THOMAS ANTHONY RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9 LAW ST, COXSACKIE, NY 12192
(518) 731-2120
(518) 731-2070
Mailing address
9 LAW ST, COXSACKIE, NY 12192
(518) 731-2120
(518) 731-2070
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004434-1
NY
Other
Enumeration date
07/08/2005
Last updated
02/24/2023
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