Grace Russo
NPI #1215187133 in Sparta, New Jersey
Provider Information
- NPI Number
- 1215187133
- Entity Type
- Individual
- Name
- Grace Russo
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Early Intervention Provider Agency
- Enumeration Date
- Sep 28, 2008
- Last Updated
- Sep 28, 2008
Practice Location
- Address
- 43 CONESTOGA TRL
- City
- Sparta
- State
- New Jersey
- ZIP Code
- 07871-2509
- Phone
- (914) 443-0138
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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|---|---|
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