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Nicole Russell, PA-C
Surgical Physician Assistant in Roslyn, New York
NPI 1629753975

Nicole Russell is a Surgical Physician Assistant based in Westbury, NY and is specialized in Surgical. Nicole Russell practices in Roslyn, NY and has the professional credentials of PA-C. The NPI Number for Nicole Russell is 1629753975 and holds a License No. (New York).

The current practice location address for Nicole Russell is 100 Port Washington Blvd, Roslyn, NY and can be reached out via phone at 516-562-6006.

Location: 100 Port Washington Blvd, Roslyn, NY, 11590-6315
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629753975
Provider Name
Nicole Russell
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
100 Port Washington Blvd, Roslyn, NY, 11590-6315
Phone Number
516-562-6006
Fax Number
Provider Enumeration Date
06/15/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
100 Port Washington Blvd
City
Roslyn
State
New York
Zip
11576-1347
Phone Number
516-562-6006
Fax Number
person
Provider Business Mailing Address Details
Address
100 Port Washington Blvd
City
Roslyn
State
New York
Zip
11576-1347
Phone Number
516-562-6006
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
363AS0400X
License No.
()
Definition
Definition to come...
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