| Karen Russo Phd Llc | |
|
500 Creek View Rd Suite 109 Newark DE 19711-8549 | |
| (302) 738-3140 | |
| (302) 454-8026 |
| Full Name | Karen Russo Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 500 Creek View Rd, Newark, Delaware |
| Authorized Official Name and Position | Karen Russo (OWNER, PSYCHOLOGIST) |
| Authorized Official Contact | 3027383140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Karen Russo Phd Llc 500 Creek View Rd Suite 109 Newark DE 19711-8549 Ph: (302) 738-3140 | Karen Russo Phd Llc 500 Creek View Rd Suite 109 Newark DE 19711-8549 Ph: (302) 738-3140 |
| NPI Number | 1104188762 |
|---|---|
| Provider Enumeration Date | 06/11/2012 |
| Last Update Date | 04/01/2015 |
| Medicare PECOS PAC ID | 7719135433 |
|---|---|
| Medicare Enrollment ID | O20120920000644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104188762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | B1-0000259 (Delaware) | Primary |
| Provider Name | Karen R Russo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073529905 PECOS PAC ID: 9032255393 Enrollment ID: I20090930000442 |
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