Russin, Simon R
Russin, Simon R is an sole proprietor health care provider with primary practice located at 301 E City Ave Suite G2, Bala Cynwyd PA 19004-1708. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Russin, Simon R can be contacted via phone (610) 617-4177.Contact Information
Primary practice address
301 E City Ave Suite G2
Bala Cynwyd PA 19004-1708
Phone: (610) 617-4177
Fax: (610) 617-4170
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | OS009908L | Pennsylvania |
Profile Details
| NPI number | 1407852049 |
|---|---|
| LBN Legal business name | Russin, Simon R |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 27th, 2005 |
| Last updated | May 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 | 1407852049 | NPPES |
| Pennsylvania | MEDICAID | 001697374 | |
| Pennsylvania | Other | 10935353 |
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