Russo, Matthew John
Russo, Matthew John is an individual health care provider with primary practice located at 7 Essex Green Dr Suite 2, Peabody MA 01960-2961. He recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as his primary health care specialty. Russo, Matthew John can be contacted via phone (978) 532-6650.Contact Information
Primary practice address
7 Essex Green Dr Suite 2
Peabody MA 01960-2961
Phone: (978) 532-6650
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | 777 | Massachusetts |
Profile Details
| NPI number | 1013946417 |
|---|---|
| LBN Legal business name | Russo, Matthew John |
| Credentials | M.S., CCC-A |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Jan 14th, 2009 - about 15 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 | 1013946417 | NPPES |
| Massachusetts | MEDICAID | 5104378 |
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