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Contact Information

DOMENICK RUSSOLELLO
1141 ROUTE 55
STE A
LAGRANGEVILLE, NY12540-5005
 Phone: 845-895-1115
 Fax: 845-895-1116
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for DOMENICK RUSSOLELLO · (Male)

NPI Number 1750836078
Status Active
Credentials
Entity Individual
Enumeration date 08/16/2016
Last updated 08/16/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 040777
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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