MR. Sam Dominick Russo, MPAS is a medical physician assistant in New York, NY with 10 years of experience. MR. Sam Dominick Russo, MPAS NPI is 1164823787. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
650 W 168TH ST
NEW YORK, NY
ZIP 10032-702
Phone: (212) 305-7367
The NPI 1164823787 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 9/15/2014 and was last updated on 9/15/2014.