Russell, Tishon

Russell, Tishon is an individual health care provider with primary practice located at 13325 220Th St , Springfield Gardens NY 11413-1636. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Russell, Tishon can be contacted via phone (718) 471-4881.

Contact Information

Primary practice address
13325 220Th St Springfield Gardens NY 11413-1636
Phone: (718) 471-4881
Fax: (718) 337-1535
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1518191196
LBN Legal business name Russell, Tishon
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2009
Last updated May 11th, 2009 - about 15 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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