Russo, Stephen John
Russo, Stephen John is an individual health care provider with primary practice located at 302 Willis Avenue , Mineola NY 11501. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Russo, Stephen John can be contacted via phone (516) 448-3015.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0113131 | New York |
Profile Details
| NPI number | 1093826778 |
|---|---|
| LBN Legal business name | Russo, Stephen John |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jul 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093826778 | NPPES |
| New York | MEDICAID | 01527119 |
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