Provider Demographics
NPI:1548200264
Name:RUSSELL E. WINDSOR, M.D., P.C.
Entity Type:Organization
Organization Name:RUSSELL E. WINDSOR, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-606-1166
Mailing Address - Street 1:535 EAST 70TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-606-1166
Mailing Address - Fax:212-794-0758
Practice Address - Street 1:535 EAST 70TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-606-1166
Practice Address - Fax:212-794-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161910-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty