MARK JACK RUSS

GLEN OAKS, NY
NPI1437213402
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: NY  146749)
Enumeration Date2006-12-21
Last Update Date2007-07-08
Business Address
-- MARK JACK RUSS MD
7559 263RD ST
GLEN OAKS, NY 11004-1150
Phone number: 718-470-8011
Mailing Address
-- MARK JACK RUSS MD
7559 263RD ST
GLEN OAKS, NY 11004-1150
Phone number: 718-470-8011
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