Individual provider · Type 1 NPI

Alphonso Russ Jr., L.P.N

Licensed Practical Nurse · Deer Park, NY

NPI number 1316178957 Active

Practice location

11 W 14th St
Deer Park, NY 11729-4019

Call (631) 404-0413 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X295557 (NY)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1316178957

Alphonso Russ Jr., L.P.N's National Provider Identifier is 1316178957, issued on Jul 30, 2009. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Deer Park, NY. The record was last updated on Jul 30, 2009.