Provider Demographics
NPI:1891470308
Name:RUSSO, JAMES W (DPT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:RUSSO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:672 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5008
Mailing Address - Country:US
Mailing Address - Phone:914-722-2400
Mailing Address - Fax:914-722-2406
Practice Address - Street 1:672 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5008
Practice Address - Country:US
Practice Address - Phone:914-722-2400
Practice Address - Fax:914-722-2406
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYP12214601225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist