Russo, Jessica Dean
Russo, Jessica Dean is an sole proprietor health care provider with primary practice located at 230 S. Broad St. Ste 600, Phila PA 19102-4121. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Russo, Jessica Dean can be contacted via phone (215) 545-2748.Contact Information
Primary practice address
230 S. Broad St. Ste 600
Phila PA 19102-4121
Phone: (215) 545-2748
Fax: (215) 545-2749
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PS015317 | Pennsylvania |
Profile Details
| NPI number | 1659401990 |
|---|---|
| LBN Legal business name | Russo, Jessica Dean |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 6th, 2007 |
| Last updated | Feb 24th, 2010 - about 14 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 | 1659401990 | NPPES |
| Pennsylvania | Other | 1522333 | BC/BS |
| Pennsylvania | Other | 1522333 | BC/BS |
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