| Abby Russin, Ph.d., Llc | |
|
1516 Wyoming Ave Forty Fort PA 18704-4225 | |
| (570) 287-5200 | |
| (570) 609-1551 |
| Full Name | Abby Russin, Ph.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1516 Wyoming Ave, Forty Fort, Pennsylvania |
| Authorized Official Name and Position | Abby Russin (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 5702875200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abby Russin, Ph.d., Llc 1516 Wyoming Ave Forty Fort PA 18704-4225 Ph: (570) 287-5200 | Abby Russin, Ph.d., Llc 1516 Wyoming Ave Forty Fort PA 18704-4225 Ph: (570) 287-5200 |
| NPI Number | 1699912691 |
|---|---|
| Provider Enumeration Date | 01/13/2009 |
| Last Update Date | 02/28/2024 |
| Certification Date | 02/28/2024 |
| Medicare PECOS PAC ID | 0042373151 |
|---|---|
| Medicare Enrollment ID | O20090415000486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699912691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PS016373 (Pennsylvania) | Primary |
| Provider Name | Abby R Reese |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972704419 PECOS PAC ID: 5395839476 Enrollment ID: I20090415000476 |
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