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General NPI Number Information
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NPI Number | 1225561509
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Entity Type | Individual
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Provider Name | RONALD CHARLES RUSSO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2017
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 2546 BALLTOWN RD STE 300
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City | SCHENECTADY
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State | NY
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Zip | 12309-1079
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Country | US
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Telephone | 518-377-8184
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Fax | 518-370-5143
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Provider Business Mailing Address
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Address Line | PO BOX 14890
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City | ALBANY
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State | NY
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Zip | 12212-4890
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Country | US
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Telephone | 518-525-5601
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Fax | 518-649-4094
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 306683
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License Number State | NY
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