Russo, Deborah J.
Russo, Deborah J. is an individual health care provider with primary practice located at 905 Johns Hopkins Dr Ecu Physicians Psychiatric Medicine Outpatient Center, Greenville NC 27834-7225. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Russo, Deborah J. can be contacted via phone (252) 744-1406.Contact Information
Primary practice address
905 Johns Hopkins Dr Ecu Physicians Psychiatric Medicine Outpatient Center
Greenville NC 27834-7225
Phone: (252) 744-1406
Fax: (252) 744-2419
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 3986 | North Carolina |
Profile Details
| NPI number | 1629197546 |
|---|---|
| LBN Legal business name | Russo, Deborah J. |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2007 |
| Last updated | Nov 9th, 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 | 1629197546 | NPPES |
| North Carolina | Other | 162G7 | BCBSNC |
| North Carolina | MEDICAID | 6001277 | BCBSNC |
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