National Provider Identifier
Kelly Lynn Russo
Kelly Lynn Russo is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Buffalo, NY and a listed phone number of (716) 828-9560.
Profile Overview
- NPI
- 1073822409
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- October 04, 2010
- Last Updated
- October 04, 2010
Practice Location
- 51 St Johns Parkside
- Buffalo, NY 14210-2515
Phone: (716) 828-9560
Mailing Address
- 25 Leonard Drive
- Depew, NY 14043-2558
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1073822409
- Entity Type
- Individual
- Last Name
- Russo
- First Name
- Kelly
- Middle Name
- Lynn
- Provider Other Last Name
- Krzyzanowski
- Provider Other First Name
- Kelly
- Provider Other Middle Name
- Lynn
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 25 Leonard Drive
- Mailing City
- Depew
- Mailing State
- NY
- Mailing ZIP Code
- 14043-2558
- Mailing Country
- US
- Mailing Phone
- (716) 685-9161
- Practice Street Address
- 51 St Johns Parkside
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14210-2515
- Practice Country
- US
- Practice Phone
- (716) 828-9560
- Practice Fax
- (716) 828-9460
- Enumeration Date
- October 04, 2010
- Last Updated
- October 04, 2010
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)