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NPI 1487872479

IndividualActive

Russell Koutrouby, LAC

NPI 1487872479 · Mechanotherapist · Northport, NY

Provider details

NPI number: 1487872479
Entity type: Individual
Primary specialty: MechanotherapistOther Service Providers
Credential: LAC
Sex: Male
Sole proprietor: Yes
License: 2125 (NY)

Practice location

220 Fort Salonga Road

Northport, NY 11768

Phone: (631) 757-2688

More NY providers

Mailing address

22 Nevinwood Place

Huntington Station, NY 11746

Registry dates

Enumerated: 2007-04-23
Last updated: 2025-09-11

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Russell Koutrouby, LAC — NPI 1487872479, Northport, NY | NPI Central