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
Fax: (631) 853-3073
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861432064 NPPES
New York MEDICAID 01180029

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