Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. RUSSELL KOUTROUBY, LAC
Active Sole ProprietorMR. RUSSELL KOUTROUBY, LAC is a Mechanotherapist healthcare provider located in NORTHPORT, New York. NPI 1487872479 is currently active in the NPPES registry. Verify at CMS.
Mechanotherapist · NORTHPORT, NY
Registration Details
- NPI Number
- 1487872479
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 23, 2007 (19.332813838704 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
2125 (NY)8054 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
220 FORT SALONGA ROADNORTHPORT, NY, 11768Browse NY providers · Browse ZIP 11768
- Phone
- 6317572688
- Primary Specialty
-
Mechanotherapist
172M00000X
- Additional Specialty
- Mechanotherapist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.