Michael James Russo LMSW

NPI 1699947242 - Social Worker - 104100000X

NPI Details
NPI 1699947242
Gender Male
Enumeration Date 03/24/2008
Last Updated 03/24/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
19 MAIDSTONE LN
HAMPTON BAYS NY, 11946-1670, US
Phone (631) 728-8577
Fax
Business Location
19 MAIDSTONE LN
HAMPTON BAYS NY, 11946-1670, US
Phone (631) 728-8577
Fax
Toxanomy
Taxonomy Code 104100000X
License State New York
License Number 075969
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According to our database, Michael James Russo LMSW NPI is 1699947242, taxonomy code is 104100000X and license number is 075969, license state is located at New York. Michael James Russo LMSW physically located at 19 Maidstone Ln, Hampton Bays NY, 11946-1670. NPI Number Michael James Russo LMSW has the Individual type.

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1699947242 NPI number is provided on an as is basis without warranty of any kind. 1699947242 is maintained by the National Plan & Provider Enumeration System. The contents of Michael James Russo LMSW are for informational purposes only.