Mary Kathleen Russo in Beachwood - General Practice
Mary Kathleen Russo - NPI 1710030234
Mary Kathleen Russo is a General Practice in Beachwood, New Jersey. Mary Kathleen Russo practices all healthcare services and medical treatments related to General Practice. The NPI Number for Mary Kathleen Russo is 1710030234. The last update date is 2015-07-10.
Mary Kathleen Russo's current location address is 808 Spray Ave, Beachwood, New Jersey. You can contact this provider via phone number 9737475383 and fax number 7324496564. The mailing address for Mary Kathleen Russo is 808 Spray Ave, Beachwood, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Kathleen Russo |
|---|---|
| Address | 808 Spray Ave, Beachwood, New Jersey |
| Phone Number | 9737475383 |
| Fax Number | 7324496564 |
| Sole Proprietor | N |
| Credentials | D.M.D |
NPI Number Detail
| NPI Number | 1710030234 |
|---|---|
| Provider Enumeration Date | 2007-01-19 |
| Last Updated Date | 2015-07-10 |
Provider Mailing Address Detail
| Address | 808 Spray Ave |
|---|---|
| City | Beachwood |
| State | New Jersey (NJ) |
| Post Code | 87224626 |
| Phone Number | 9737475383 |
| Fax Number | 7324496564 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 22DI02293800 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the Mary Kathleen Russo's unique identification number?
The Mary Kathleen Russo has been assigned the NPI (National Provider Identifier) Number 1710030234 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical location address where Mary Kathleen Russo's facilities are situated?
The facilities of Mary Kathleen Russo are physically located at the following address: 808 Spray Ave, Beachwood, NJ, 87224626.
What is the Mary Kathleen Russo's area of specialization and corresponding taxonomy classification?
The Mary Kathleen Russo's specialty field is General Practice, and it falls under the taxonomy code 1223G0001X, which categorizes healthcare providers based on their specialties.
On what date did Mary Kathleen Russo receive its 1710030234 assignment from the Centers for Medicare & Medicaid Services?
The Mary Kathleen Russo was assigned its 1710030234 on 2007-01-19, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Mary Kathleen Russo's information last updated?
The Mary Kathleen Russo's information was last updated on 2015-07-10.
NPI Number: 1952305922
Address: 1111 Professional Blvd, Dalton, GA