Portenoy, Russell Keith

Portenoy, Russell Keith is an individual health care provider with primary practice located at Mjhs Hospice And Palliative Care 39 Broadway #R Fl, New York NY 10006. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Portenoy, Russell Keith can be contacted via phone (212) 649-5560.

Contact Information

Primary practice address
Mjhs Hospice And Palliative Care 39 Broadway #R Fl New York NY 10006
Phone: (212) 649-5560
Fax: (212) 649-5544
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 146475 New York
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 2084H0002X 146475 New York

Profile Details

NPI number 1407837396
LBN Legal business name Portenoy, Russell Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated May 6th, 2021 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1407837396 NPPES
New York MEDICAID 00906634

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