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1124299631
KATHRYN D RUSSO
BOSTON, MA
NPI
1124299631
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MA 239289)
Enumeration Date
2008-03-13
Last Update Date
2008-03-13
Business Address
-- KATHRYN D RUSSO N.P.
147 MILK ST PROVIDER ENROLLMENT DEPT. - 9TH FLOOR
BOSTON, MA 02109-4806
Phone number: 617-559-8374
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Mailing Address
-- KATHRYN D RUSSO N.P.
133 BROOKLINE AVE
BOSTON, MA 02215-3904
Phone number: 617-421-1194
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