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Contact Information

SAM RUSSO, N.D., LAC, RMSK
321 MAIN ST STE B
WINOOSKI, VT05404-1380
 Phone: 802-636-4133
 Fax: 833-464-3117
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Naturopath

175F00000X
 

Acupuncturist

171100000X
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Sports Medicine

2083S0010X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for SAM RUSSO · (Male)

NPI # 1891828398
Status Active
Credentials N.D., LAC, RMSK
Entity Individual
Enumeration date 03/13/2007
Last updated 05/01/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • VT License # 091-0000176
  • VT License # 099-0000131
  • VT Medicaid 1015129
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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