Russo, Robert D.

Russo, Robert D. is an sole proprietor health care provider with primary practice located at 75 Kings Highway Cutoff Suite 1A, Fairfield CT 06824-5340. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Russo, Robert D. can be contacted via phone (203) 815-1877.

Contact Information

Primary practice address
75 Kings Highway Cutoff Suite 1A Fairfield CT 06824-5340
Phone: (203) 815-1877
Fax: (203) 538-5246
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 016805 Connecticut

Profile Details

NPI number 1114924693
LBN Legal business name Russo, Robert D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2005
Last updated Mar 7th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114924693 NPPES
Connecticut MEDICAID 001168053

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