RUSSELL PET M.D. INC NPI 1710204391

NPI Information

  • NPI: 1710204391
  • Provider Name: RUSSELL PET M.D. INC
  • Classification: Psychiatry & Neurology - 2084P0804X
  • Specialization: Child & Adolescent Psychiatry
  • Entity Type: Organization
  • Address: 4 HARTWELL ST
    FALL RIVER, MA
    ZIP 02721
  • Phone: (508) 675-0089

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NPI Details

RUSSELL PET M.D. INC is a child and adolescent psychiatry psychiatry neurology in Fall River, MA. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. RUSSELL PET M.D. INC NPI is 1710204391. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4 HARTWELL ST
FALL RIVER, MA
ZIP 02721-019
Phone: (508) 675-0089
Fax: (508) 675-2233

The provider's authorized official is L Russell Pet .
The authorized official title is President and has the following contact phone number (508) 675-0089.

The enumeration date for this NPI number is 4/22/2010 and was last updated on 4/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13154564MEDICAIDMASSACHUSETTS
2G29964MEDICARE PINMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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