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:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285615591 | NPPES |
| Connecticut | MEDICAID | 001325960 |
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