National Provider Identifier
Samuel J Russell, RPAC
Samuel J Russell, RPAC is listed in the NPPES registry with a primary specialty of Physician Assistant in Elmira, NY and a listed phone number of (607) 734-7121.
Profile Overview
- NPI
- 1902907892
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- September 26, 2006
- Last Updated
- February 17, 2020
Practice Location
- 555 Saint Josephs Blvd Ste M2
- Elmira, NY 14901-3223
Phone: (607) 734-7121
Mailing Address
- 571 Saint Josephs Blvd
- Elmira, NY 14901-3230
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1902907892
- Entity Type
- Individual
- Last Name
- Russell
- First Name
- Samuel
- Middle Name
- J
- Credential
- RPAC
- Mailing Street Address
- 571 Saint Josephs Blvd
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14901-3230
- Mailing Country
- US
- Mailing Phone
- (607) 271-2050
- Mailing Fax
- (607) 271-2099
- Practice Street Address
- 555 Saint Josephs Blvd Ste M2
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14901-3223
- Practice Country
- US
- Practice Phone
- (607) 734-7121
- Practice Fax
- (607) 734-0614
- Enumeration Date
- September 26, 2006
- Last Updated
- February 17, 2020
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- February 17, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)
- Other Identifiers
- 103367933 (PA), 03180370 (NY)