Russell, Kerry S
Russell, Kerry S is an individual health care provider with primary practice located at 800 Howard Ave Yale Physicians' Building, 2Nd Floor, New Haven CT 06519-1369. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Russell, Kerry S can be contacted via phone (203) 785-4114.Contact Information
Primary practice address
800 Howard Ave Yale Physicians' Building, 2Nd Floor
New Haven CT 06519-1369
Phone: (203) 785-4114
Fax: (203) 737-2437
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 038909 | Connecticut |
Profile Details
| NPI number | 1538157730 |
|---|---|
| LBN Legal business name | Russell, Kerry S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2005 |
| Last updated | Mar 31st, 2011 - about 13 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 | 1538157730 | NPPES |
| Connecticut | MEDICAID | 001389099 |
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