Autz, George Russell

Autz, George Russell is an individual health care provider with primary practice located at 990 Stewart Ave. , Garden City NY 11530. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Autz, George Russell can be contacted via phone (516) 222-4294.

Contact Information

Primary practice address
990 Stewart Ave. Garden City NY 11530
Phone: (516) 222-4294
Fax: (516) 222-4880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 170392 New York
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 170392-1 New York

Profile Details

NPI number 1114907383
LBN Legal business name Autz, George Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2006
Last updated Dec 29th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114907383 NPPES
New York MEDICAID 01034711

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