Russell, Anthony Henryk

Russell, Anthony Henryk is an individual health care provider with primary practice located at 100 Blossom St Cox Ll, Boston MA 02114-2606. He recently has only one registered license in Allopathic & Osteopathic Physicians / Therapeutic Radiology, which is considered as his primary health care specialty. Russell, Anthony Henryk can be contacted via phone (617) 726-8650.

Contact Information

Primary practice address
100 Blossom St Cox Ll Boston MA 02114-2606
Phone: (617) 726-8650
Fax: (617) 726-3603
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Therapeutic Radiology 2085R0203X 40275 Massachusetts

Profile Details

NPI number 1376525014
LBN Legal business name Russell, Anthony Henryk
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Dec 4th, 2012 - about 14 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 1376525014 NPPES
Massachusetts MEDICAID 2003937
Massachusetts Other J25906
Massachusetts Other 040275

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