Sam Russo is a General Practice in Winooski, Vermont. Sam Russo practices all healthcare services and medical treatments related to General Practice. The NPI Number for Sam Russo is 1891828398. The last update date is 2023-05-01.
Sam Russo's current location address is 321 Main St Ste B, Winooski, Vermont. You can contact this provider via phone number 8026364133 and fax number 8334643117. The mailing address for Sam Russo is 321 Main St Ste B, Winooski, Vermont. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Sam Russo |
|---|---|
| Address | 321 Main St Ste B, Winooski, Vermont |
| Phone Number | 8026364133 |
| Fax Number | 8334643117 |
| Sole Proprietor | N |
| Credentials | N.D., LAC, |
NPI Number Detail
| NPI Number | 1891828398 |
|---|---|
| Provider Enumeration Date | 2007-03-13 |
| Last Updated Date | 2023-05-01 |
Provider Mailing Address Detail
| Address | 321 Main St Ste B |
|---|---|
| City | Winooski |
| State | Vermont (VT) |
| Post Code | 54041380 |
| Phone Number | 8026364133 |
| Fax Number | 8334643117 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
| Licence No | 099-0000131 |
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Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1015129 | VT | -- |
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What is the unique 10-digit identification code assigned to Sam Russo by the Centers for Medicare & Medicaid Services?
The Sam Russo has been issued the NPI (National Provider Identifier) 1891828398, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Sam Russo located?
The Sam Russo is located at 321 Main St Ste B, Winooski, VT 54041380.
What is Sam Russo's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Sam Russo's specialized field of practice is General Practice, and the corresponding taxonomy code that categorizes this area of specialization is 208D00000X.
On what date was the 1891828398 assigned to Sam Russo?
The Sam Russo was issued its 1891828398 on 2007-03-13, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Sam Russo most recently updated or revised?
The information pertaining to Sam Russo, including its address, specialty, and other relevant details, was last updated or revised on 2023-05-01.