Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 273825 | NY |
NPI | 1982866463 |
---|---|
Provider Name | Dr. Christen M Russo |
First Address | Brooklyn, NY 11215-3609 |
Second Address | Brooklyn, NY 11215-3609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 04/10/2016 |