Dr Patrick Kelly Russell, DNAP, CRNA | |
1 Bay Ave, Montclair, NJ 07042-4837 | |
(973) 429-6000 | |
Not Available |
Full Name | Dr Patrick Kelly Russell |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 1 Bay Ave, Montclair, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1699485227 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 95001877 (California) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 26NJ01401400 (New Jersey) | Primary |
Entity Name | New Jersey Healthcare Specialists Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174585780 PECOS PAC ID: 2668385253 Enrollment ID: O20031110000555 |
Mailing Address | Practice Location Address |
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Dr Patrick Kelly Russell, DNAP, CRNA 157 Clarken Dr, West Orange, NJ 07052-3429 Ph: (619) 675-4910 | Dr Patrick Kelly Russell, DNAP, CRNA 1 Bay Ave, Montclair, NJ 07042-4837 Ph: (973) 429-6000 |
Mr. Timothy L. Murry, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Bay Ave, Montclair, NJ 07042 Phone: 973-429-6250 | |
Michelle Medina, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Bay Ave, Anesthesia Office, Montclair, NJ 07042 Phone: 973-429-6219 Fax: 845-547-0740 | |
Ljiljana Kovacevic, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 120 Chestnut St, Montclair, NJ 07042 Phone: 973-842-0464 Fax: 973-972-2357 | |
Erin Ferber, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Bay Avenue, Mountainside Hospital, Montclair, NJ 07042 Phone: 973-429-6000 Fax: 845-357-5777 | |
Marci Viola, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Bay Ave, Anesthesia Office, Montclair, NJ 07042 Phone: 973-429-6219 Fax: 845-547-0740 | |
Jessica Sanchez, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1 Bay Ave, Montclair, NJ 07042 Phone: 973-429-6000 |