Lauren Russo

NPI #1679340830 in Deer Park, New York

Provider Information

NPI Number: 1679340830
Entity Type: Individual
Name: Lauren Russo
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Dec 7, 2023
Last Updated: Dec 7, 2023

Practice Location

Address: 505 GRAND BLVD STE 1
City: Deer Park
State: New York
ZIP Code: 11729-5300
Phone: (631) 243-1313

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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