Russo, Mark

Russo, Mark is an individual health care provider with primary practice located at 5823 Widewaters Pkwy , East Syracuse NY 13057-3081. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Russo, Mark can be contacted via phone (315) 701-4000.

Contact Information

Primary practice address
5823 Widewaters Pkwy East Syracuse NY 13057-3081
Phone: (315) 701-4000
Fax: (315) 701-4091
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 002388-1 New York

Profile Details

NPI number 1083024327
LBN Legal business name Russo, Mark
Credentials ATC, CSCS
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2014
Last updated May 7th, 2014 - about 10 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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