Provider Demographics
NPI:1649245911
Name:CAMHI, RUSSELL F (DO, ATC)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:F
Last Name:CAMHI
Suffix:
Gender:M
Credentials:DO, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 NORTHERN BLVD
Mailing Address - Street 2:#200
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5207
Mailing Address - Country:US
Mailing Address - Phone:516-723-2663
Mailing Address - Fax:
Practice Address - Street 1:611 NORTHERN BLVD
Practice Address - Street 2:#200
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5207
Practice Address - Country:US
Practice Address - Phone:516-723-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271827207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine