| Glenn Russo, | |
|
16 E 52nd St Fl 6, New York, NY 10022-5306 | |
| (347) 943-8046 | |
| Not Available |
| Full Name | Glenn Russo |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 16 E 52nd St Fl 6, New York, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033828488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (New Jersey) | Primary |
| Provider Name | Sports Physical Therapy Occupational Therapy And Rehabilitation Servic |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1770540593 PECOS PAC ID: 0446140446 Enrollment ID: O20040315001603 |
| Provider Name | Professional Occupational & Physical Therapy Pllc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1205296902 PECOS PAC ID: 3779873401 Enrollment ID: O20160608000715 |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn Russo, 576 Broadhollow Rd, Melville, NY 11747-5002 Ph: (631) 359-5859 | Glenn Russo, 16 E 52nd St Fl 6, New York, NY 10022-5306 Ph: (347) 943-8046 |
Wilbert Lao, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 37 W 26th St, Suite 302, New York, NY 10010 Phone: 718-285-0588 Fax: 718-285-9323 | |
Elisabeth Anne Frank, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 501 5th Ave, 22nd Floor, New York, NY 10017 Phone: 404-849-5770 | |
Ryanne Tanae Glasper, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 230 W 38th St Fl 18, New York, NY 10018 Phone: 212-997-7490 Fax: 212-007-7492 | |
Miss Shari Ilise Nadel, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 147 W 35th St, Suite 407, New York, NY 10001 Phone: 917-591-8494 | |
Katherine Spencer, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 201 W 108th St Apt 41, New York, NY 10025 Phone: 585-737-2360 | |
Kunjan Shah, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 675 3rd Ave, 5th Floor, New York, NY 10017 Phone: 212-204-5144 | |
Mr. Ramoncito Tiosejo Dizon, RPT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 1615 Madison Ave, New York, NY 10029 Phone: 212-860-5803 Fax: 212-860-6095 |