Russo, Tanya
Russo, Tanya is an individual health care provider with primary practice located at 105 Yadkin St Suite 303, Albemarle NC 28001-3449. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Russo, Tanya can be contacted via phone (803) 532-2208.Contact Information
Primary practice address
105 Yadkin St Suite 303
Albemarle NC 28001-3449
Phone: (803) 532-2208
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0574 | South Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2015-02335 | North Carolina |
Profile Details
| NPI number | 1013906098 |
|---|---|
| LBN Legal business name | Russo, Tanya |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2005 |
| Last updated | Feb 2nd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013906098 | NPPES |
| North Carolina | MEDICAID | 1013906098 |
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