Grace, William Russell
Grace, William Russell is an sole proprietor health care provider with primary practice located at 945 Fifth Avenue , New York NY 10021-2661. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Grace, William Russell can be contacted via phone (212) 675-6826.Contact Information
Primary practice address
945 Fifth Avenue
New York NY 10021-2661
Phone: (212) 675-6826
Fax: (212) 366-1697
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 108472 | New York |
Profile Details
| NPI number | 1578565610 |
|---|---|
| LBN Legal business name | Grace, William Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Apr 25th, 2017 - about 9 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 | 1578565610 | NPPES |
| New York | Other | 311391 | MEDICARE PROVIDER ID |
| New York | Other | 133086258 | MEDICARE PROVIDER ID |
| New York | Other | NS3327 | MEDICARE PROVIDER ID |
| New York | Other | 1578565610 | MEDICARE PROVIDER ID |
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