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Individual

DR. RUSSELL STUART GOLKOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
142 PALISADE AVE, RADIOLOGY PROFESSIONAL ASSOCIATION, JERSEY CITY, NJ 07306
(201) 795-8411
Mailing address
142 PALISADE AVE, RADIOLOGY PROFESSIONAL ASSOCIATION, JERSEY CITY, NJ 07306
(201) 795-8411

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
220790
NY
174400000X
Specialist
Primary
25MA03614200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02168638
NY
01
10657403
CAQH
NY
Enumeration date
06/01/2006
Last updated
06/11/2010
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