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Individual

MRS. NADINE ANN RUSSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1534
(860) 793-3809
Mailing address
87 HARVEST LN, PLANTSVILLE, CT 06479-1041
(860) 621-5078

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary

Other

Enumeration date
06/11/2007
Last updated
07/08/2007
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