Dr. Edward Nicholas Russo
Endodontist
2171 Jericho Turnpike Suite # 145
Commack
, New York 11725
Dr. Edward Nicholas Russo
Endodontist
2171 Jericho Turnpike Suite # 145
Commack
, New York 11725
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Dr. Edward Nicholas Russo
- 2171 Jericho Turnpike Suite # 145
- Commack, NY
- Zip : 11725
- Phone :
Second Address
- Dr. Edward Nicholas Russo
- 2171 Jericho Turnpike Suite # 145
- Commack, NY
- Zip : 11725
- Fax : (631) 499-0775
- Phone : (631) 462-6888
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223E0200X | Endodontist | 040596 | NY |
National Provider Identifier
| NPI | 1003954215 |
|---|---|
| Provider Name | Dr. Edward Nicholas Russo |
| First Address | Commack, NY 11725 |
| Second Address | Commack, NY 11725 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/02/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.