Russe, Richard Jon
Russe, Richard Jon is an individual health care provider with primary practice located at 16 East Granby Rd , Granby CT 06035-2201. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Russe, Richard Jon can be contacted via phone (860) 653-3008.Contact Information
Primary practice address
16 East Granby Rd
Granby CT 06035-2201
Phone: (860) 653-3008
Fax: (860) 653-0359
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 787 | Connecticut |
Profile Details
| NPI number | 1669546842 |
|---|---|
| LBN Legal business name | Russe, Richard Jon |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669546842 | NPPES |
| Other | 410022496 | RAILROAD MEDICARE | |
| MEDICAID | 004024410 | RAILROAD MEDICARE |
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