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1164640173
NANCY ANN RUSSELL
SMITHTOWN, NY
NPI
1164640173
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 0044131)
Enumeration Date
2007-04-23
Last Update Date
2007-07-08
Business Address
MRS. NANCY ANN RUSSELL PA
50 ROUTE 25A
SMITHTOWN, NY 11787
Phone number: 631-862-3110
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Mailing Address
MRS. NANCY ANN RUSSELL PA
350 BARTON AVE
PATCHOGUE, NY 11772
Phone number: 631-475-1334
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