Pet, L. Russell

Pet, L. Russell is an individual health care provider with primary practice located at 4 Hartwell St Ste 1 , Fall River MA 02721-3019. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Pet, L. Russell can be contacted via phone (508) 675-0089.

Contact Information

Primary practice address
4 Hartwell St Ste 1 Fall River MA 02721-3019
Phone: (508) 675-0089
Fax: (508) 675-2233
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 150723 Massachusetts
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 8850 Rhode Island

Profile Details

NPI number 1194745257
LBN Legal business name Pet, L. Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Apr 23rd, 2020 - about 5 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 1194745257 NPPES
Massachusetts MEDICAID 3154564

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