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General NPI Number Information
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NPI Number | 1538246608
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Entity Type | Individual
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Provider Name | BARBARA KATHRYN RUSSELL D.O.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1650 SELWYN AVE SUITE 8B
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City | BRONX
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State | NY
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Zip | 10457-7626
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Country | US
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Telephone | 718-579-2650
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Fax | 718-579-2659
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Provider Business Mailing Address
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Address Line | 70 E 96TH ST APARTMENT 13A
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City | NEW YORK
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State | NY
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Zip | 10128-0745
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Country | US
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Telephone | 212-288-9095
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Fax |
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 185869
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License Number State | NY
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