Russo, Dennis
Russo, Dennis is an individual health care provider with primary practice located at 225 Rabro Dr , Hauppauge NY 11788-4241. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Russo, Dennis can be contacted via phone (631) 853-3057.Contact Information
Primary practice address
225 Rabro Dr
Hauppauge NY 11788-4241
Phone: (631) 853-3057
Fax: (631) 853-3073
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 154642 | New York |
Profile Details
| NPI number | 1861432064 |
|---|---|
| LBN Legal business name | Russo, Dennis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Dec 24th, 2007 - about 19 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 | 1861432064 | NPPES |
| New York | MEDICAID | 01180029 |
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