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Dr. Brian James Di Russa, DC
Chiropractor in Southampton, New York
NPI 1639243462

Brian James Di Russa is a Chiropractor based in Southampton, NY. Brian James Di Russa practices in Southampton, NY and has the professional credentials of DC. The NPI Number for Brian James Di Russa is 1639243462 and holds a License No. X007686-1 (New York).

The current practice location address for Brian James Di Russa is 80 Marys Ln, Southampton, NY and can be reached out via phone at 631-283-7474 and via fax at 631-283-7423.

Location: 80 Marys Ln, Southampton, NY, 11968-5614
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639243462
Provider Name
Brian James Di Russa
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
80 Marys Ln, Southampton, NY, 11968-5614
Phone Number
631-283-7474
Fax Number
631-283-7423
Provider Enumeration Date
11/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5803948 01 NY GHI PROVIDER NUMBER
75723 01 NY VYTRA HIP PROVIDER NUMBER
CO 7686-1 01 NY WORKERS COMPENSATION
institution
Provider Business Practice Location Address Details
Address
80 Marys Ln
City
Southampton
State
New York
Zip
11968-5614
Phone Number
631-283-7474
Fax Number
631-283-7423
person
Provider Business Mailing Address Details
Address
80 Marys Ln
City
Southampton
State
New York
Zip
11968-5614
Phone Number
631-283-7474
Fax Number
631-283-7423
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
X007686-1 (New York)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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