Russo, Carol A

Russo, Carol A is an individual health care provider with primary practice located at 7559 263Rd St The Zucker Hillside Hospital, Ars, Littauer Bldg., Glen Oaks NY 11004-1150. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Russo, Carol A can be contacted via phone (718) 470-8940.

Contact Information

Primary practice address
7559 263Rd St The Zucker Hillside Hospital, Ars, Littauer Bldg. Glen Oaks NY 11004-1150
Phone: (718) 470-8940
Fax: (718) 470-6408
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X F400493-1 New York

Profile Details

NPI number 1396773420
LBN Legal business name Russo, Carol A
Credentials N.P.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Mar 27th, 2008 - about 16 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 1396773420 NPPES
New York MEDICAID 01382663

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