Michael Russ, MD PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

188435 Issued in NY

Legal business name

MICHAEL RUSS, MD PC

Practice address

70 Glen St
Suite 380
Glen Cove, NY 11542-2855

Phone

(516) 759-2424

Fax

(516) 759-6627

NPI assigned

Jul 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Loyd Russ, MD

Title

President

Phone

(516) 255-0620

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437184959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DALY BLVD",
            "address_2": "#2505",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115726000",
            "telephone_number": "516-255-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN ST",
            "address_2": "SUITE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422855",
            "telephone_number": "516-759-2424",
            "fax_number": "516-759-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL RUSS, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LOYD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-255-0620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "188435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Meyer, LCSW
• Barbara Berke Meyers, PSY.D.
• Gail S Meyrowitz, MA
• Michael Deangelis DO PC
• Michael R Dubin MD and William R Basta MD P C
• Diana Mikhail, PHARM D
• Eileen Milano, MD
• Pilar Miller, LPN
• Robert Miller
• Josevito Miranda, RN

• Medical Specialty Clinic/Center in Glen Cove, NY
• Providers in Glen Cove, NY by specialty
• Medical Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.