Russell, Robert J

Russell, Robert J is an individual health care provider with primary practice located at 1 Hawley St , Binghamton NY 13901-3102. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Russell, Robert J can be contacted via phone (607) 778-1118.

Contact Information

Primary practice address
1 Hawley St Binghamton NY 13901-3102
Phone: (607) 778-1118
Fax: (607) 778-1164
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 009923 New York
Behavioral Health & Social Service Providers / Clinical 103TC0700X 009923 New York

Profile Details

NPI number 1245272178
LBN Legal business name Russell, Robert J
Credentials EDD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jul 8th, 2007 - about 18 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 1245272178 NPPES
New York MEDICAID 06800009923

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