Mr Russell Koutrouby, LAC is a
Mechanotherapist based in Northport, New York. Mr Russell Koutrouby is licensed to practice in New York (license number 8054) and his current practice location is
220 Fort Salonga Road, Northport, New York. He can be reached at his office (for appointments etc.) via phone at
(631) 757-2688.
NPI number for Mr Russell Koutrouby is 1487872479 and his current mailing address is 22 Nevinwood Place, Huntington Station, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1487872479.
Healthcare Provider's Profile
| Full Name | Mr Russell Koutrouby |
|---|
| Gender | Male |
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| Speciality | Mechanotherapist |
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| Location | 220 Fort Salonga Road, Northport, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1487872479
- Provider Enumeration Date: 04/23/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Russell Koutrouby such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1487872479 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 171100000X | Acupuncturist | 2125 (New York) | Primary |
| 172M00000X | Mechanotherapist | 8054 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Russell Koutrouby is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Russell Koutrouby, LAC
22 Nevinwood Place,
Huntington Station, NY 11746
Ph: (631) 385-8314 | Mr Russell Koutrouby, LAC
220 Fort Salonga Road,
Northport, NY 11768
Ph: (631) 757-2688 |
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