Dr RUSSELL J MONGIOVI is a male medical professional, specializing in Podiatry. He graduated in 1990 from Ohio College Of Podiatric Medicine.
SPA PODIATRY, PC
3 HEMPHILL PL
SUITE 111
BALLSTON SPA
NY
120204420
Tel: 5188995338
| Npi | 1104852136 |
| Pac Id | 6709956899 |
| Professional Enrollment Id | I20080602000217 |
| Last Name | MONGIOVI |
| First Name | RUSSELL |
| Middle Name | J |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OHIO COLLEGE OF PODIATRIC MEDICINE |
| Graduation Year | 1990 |
| Primary Specialty | PODIATRY |
| Secondary Specialty 1 | |
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| Organization Legal Name | SPA PODIATRY, PC |
| Group Practice Pac Id | 6800966995 |
| Number Of Group Practice Members | 2 |
| Line 1 Street Address | 3 HEMPHILL PL |
| Line 2 Street Address | SUITE 111 |
| Marker Of Address Line 2 Suppression | |
| City | BALLSTON SPA |
| State | NY |
| Zip Code | 120204420 |
| Phone Number | 5188995338 |
| Hospital Affiliation Ccn 1 | 330222 |
| Hospital Affiliation Lbn 1 | SARATOGA HOSPITAL |
| Hospital Affiliation Ccn 2 | |
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| Professional Accepts Medicare Assignment | Y |
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