Provider Demographics
NPI:1093993958
Name:CHARNO, RUSSELL MARC (DC)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:MARC
Last Name:CHARNO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 W MARKET ST # 4
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1413
Mailing Address - Country:US
Mailing Address - Phone:516-316-4589
Mailing Address - Fax:
Practice Address - Street 1:47 W MARKET ST # 4
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1413
Practice Address - Country:US
Practice Address - Phone:516-316-4589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-03
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005249-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor