Provider Demographics
NPI:1649295924
Name:RUSS, FEIGIE (MS)
Entity type:Individual
Prefix:MRS
First Name:FEIGIE
Middle Name:
Last Name:RUSS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 E 12TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5232
Mailing Address - Country:US
Mailing Address - Phone:718-513-4986
Mailing Address - Fax:
Practice Address - Street 1:1280 E 12TH ST APT 4A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5232
Practice Address - Country:US
Practice Address - Phone:718-513-4986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist