Dr. John Russo
Endodontist
535 Saybrook Rd
Middletown
, Connecticut 06457-4743
Dr. John Russo
Endodontist
535 Saybrook Rd
Middletown
, Connecticut 06457-4743
(860) 232-1132
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Dr. John Russo
- 836 Farmington Ave Suite 115
- West Hartford, CT
- Zip : 06119-1505
- Fax : (860) 232-1132
- Phone : (860) 232-0033
Second Address
- Dr. John Russo
- 535 Saybrook Rd
- Middletown, CT
- Zip : 06457-4743
- Fax : (860) 344-0522
- Phone : (860) 347-7497
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223E0200X | Endodontist | 4961 | CT |
National Provider Identifier
| NPI | 1053334086 |
|---|---|
| Provider Name | Dr. John Russo |
| First Address | West Hartford, CT 06119-1505 |
| Second Address | Middletown, CT 06457-4743 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/07/2006 |
| 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.