Individual
CHRISTOPHER J RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
4 WASHINGTON SQUARE VLG APT 1P, NEW YORK, NY 10012-1901
(518) 350-9330
Mailing address
148 KENT ST APT 1, BROOKLYN, NY 11222-2140
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
107292
NY
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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