Russo, Eileen
Russo, Eileen is an individual health care provider with primary practice located at 402 East Main Street , Waterbury CT 06702. 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, Eileen can be contacted via phone (203) 755-1143.Contact Information
Primary practice address
402 East Main Street
Waterbury CT 06702
Phone: (203) 755-1143
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | LADC000276 | Connecticut |
Profile Details
| NPI number | 1336339068 |
|---|---|
| LBN Legal business name | Russo, Eileen |
| Credentials | LADC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2007 |
| Last updated | Jul 30th, 2007 - about 17 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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