Russo, Sandra Ann

Russo, Sandra Ann is an individual health care provider with primary practice located at 990 Stewart Ave , Garden City NY 11530-4822. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Russo, Sandra Ann can be contacted via phone (516) 222-2022.

Contact Information

Primary practice address
990 Stewart Ave Garden City NY 11530-4822
Fax: (516) 222-8475
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 203514-1 New York

Profile Details

NPI number 1770539918
LBN Legal business name Russo, Sandra Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Aug 29th, 2013 - about 13 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 1770539918 NPPES
New York MEDICAID 01665296

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