Russi, Mark B

Russi, Mark B is an individual health care provider with primary practice located at 135 College St Third Floor, New Haven CT 06510-2483. He recently has only one registered license in Allopathic & Osteopathic Physicians / Occupational Medicine, which is considered as his primary health care specialty. Russi, Mark B can be contacted via phone (203) 785-4197.

Contact Information

Primary practice address
135 College St Third Floor New Haven CT 06510-2483
Phone: (203) 785-4197
Fax: (203) 785-7391
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 032596 Connecticut

Profile Details

NPI number 1285615591
LBN Legal business name Russi, Mark B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2005
Last updated Apr 1st, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285615591 NPPES
Connecticut MEDICAID 001325960

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