Dr. Joseph Louis Russo
Chiropractic Sports Physician
500 Park Blvd
Massapequa Park
, New York 11762-2742
Dr. Joseph Louis Russo
Chiropractic Sports Physician
500 Park Blvd
Massapequa Park
, New York 11762-2742
(516) 798-8586
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About
Features
Specialties
- Chiropractic Sports Physician
Languages spoken
- English
Location
First Address
- Dr. Joseph Louis Russo
- 500 Park Blvd
- Massapequa Park, NY
- Zip : 11762-3042
- Fax : (516) 798-8586
- Phone : (516) 798-8363
Second Address
- Dr. Joseph Louis Russo
- 500 Park Blvd
- Massapequa Park, NY
- Zip : 11762-2742
- Fax : (516) 798-8586
- Phone : (516) 798-8363
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NS0005X | Chiropractic Sports Physician | X00003447 | NY |
National Provider Identifier
| NPI | 1053393884 |
|---|---|
| Provider Name | Dr. Joseph Louis Russo |
| First Address | Massapequa Park, NY 11762-3042 |
| Second Address | Massapequa Park, NY 11762-2742 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/11/2005 |
| Last Update Date | 10/10/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T52428 | (02) | NY |
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.