Provider Demographics
NPI:1992965271
Name:RUSSELL, CORTESSA LYNN (MD)
Entity type:Individual
Prefix:
First Name:CORTESSA
Middle Name:LYNN
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:ANESTHESIOLOGY SERVICES OF CPMC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-9876
Mailing Address - Fax:646-317-3165
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:ANESTHESIOLOGY SERVICES OF CPMC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-9876
Practice Address - Fax:646-317-3165
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY248548207L00000X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology