Russo, Diane
Russo, Diane is an sole proprietor health care provider with primary practice located at 281 Phelps Ln , North Babylon NY 11703-4005. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Russo, Diane can be contacted via phone (631) 422-7676.Contact Information
Primary practice address
281 Phelps Ln
North Babylon NY 11703-4005
Phone: (631) 422-7676
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1205474640 |
|---|---|
| LBN Legal business name | Russo, Diane |
| Credentials | CASAC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 17th, 2019 |
| Last updated | Nov 27th, 2023 - about 2 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 | 1205474640 | NPPES |
| New York | Other | 0009943 | OASAS CASAC |
Popular Providers
-
Murphy-Schmitt, Clarice
281 Phelps Ln , North Babylon NY 11703-4005 -
Baumgartner, Amy Karol
74 Fire Island Ave 2Nd Floor, Babylon NY 11702-3531 -
O'Sullivan Smith, Elizabeth
281 Phelps Lane , North Babylon NY 11703 -
Lenox, Ariana
74 Fire Island Ave Ste 201 , Babylon NY 11702-3531 -
St. Bernard, Valerie Jean
281 Phelps Ln , North Babylon NY 11703-4045 -
Leff, Meryl Susan
400 W Main St Suite 338, Babylon NY 11702-3012 -
Sloan, Stephanie
281 Phelps Ln Drug And Alcohol Services, North Babylon NY 11703-4005 -
Alfred, Kenrick
608 Johnson Avenue Suite 2, North Babylon NY 11703-1208