Individual
KORAH ANN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
236 BURTS RD, KIRKWOOD, NY 13795-1731
(877) 426-3307
Mailing address
145 BARKER RD APT A, WHITNEY POINT, NY 13862-2608
(607) 206-3195
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
3182214
NY
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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