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Geoffrey M Russell
Student in an Organized Health Care Education/Training Program in Stony Brook, New York
NPI 1487281044

Geoffrey M Russell is a Student in an Organized Health Care Education/Training Program based in Stony Brook, NY. Geoffrey M Russell practices in Stony Brook, NY. The NPI Number for Geoffrey M Russell is 1487281044 and holds a License No. (New York).

The current practice location address for Geoffrey M Russell is 101 Nicolls Rd Rm 175, Stony Brook, NY and can be reached out via phone at 631-444-3005 and via fax at 631-444-7534.

Location: 101 Nicolls Rd Rm 175, Stony Brook, NY, 11794-8430
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487281044
Provider Name
Geoffrey M Russell
Credential
Provider Entity Type
Individual
Gender
Male
Address
101 Nicolls Rd Rm 175, Stony Brook, NY, 11794-8430
Phone Number
631-444-3005
Fax Number
631-444-7534
Provider Enumeration Date
03/24/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
101 Nicolls Rd Rm 175
City
Stony Brook
State
New York
Zip
11794-8430
Phone Number
631-444-3005
Fax Number
631-444-7534
person
Provider Business Mailing Address Details
Address
101 Nicolls Rd Rm 175
City
Stony Brook
State
New York
Zip
11794-8430
Phone Number
631-444-3005
Fax Number
631-444-7534
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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