Russell, Carol Mae
Russell, Carol Mae is an individual health care provider with primary practice located at 1 Bay Ave , Montclair NJ 07042-4837. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Russell, Carol Mae can be contacted via phone (973) 429-6000.Contact Information
Primary practice address
1 Bay Ave
Montclair NJ 07042-4837
Phone: (973) 429-6000
Fax: (973) 429-6209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 238185 | New York |
Profile Details
| NPI number | 1265580096 |
|---|---|
| LBN Legal business name | Russell, Carol Mae |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 8th, 2007 |
| Last updated | Feb 20th, 2017 - about 7 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 | 1265580096 | NPPES |
| New York | MEDICAID | 02832057 |
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