National Provider Identifier
Patricia Renee Russo
Patricia Renee Russo is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Tonawanda, NY and a listed phone number of (716) 831-1850.
Profile Overview
- NPI
- 1114656212
- Provider Type
- Individual
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- June 06, 2022
- Last Updated
- January 27, 2025
Practice Location
- 100 Niagara St
- Tonawanda, NY 14150-1104
Phone: (716) 831-1850
Mailing Address
- 55 Dodge RD
- Getzville, NY 14068-1205
Specialties
- Mental Health Counselor (101YM0800X)
Full Record
- NPI
- 1114656212
- Entity Type
- Individual
- Last Name
- Russo
- First Name
- Patricia
- Middle Name
- Renee
- Mailing Street Address
- 55 Dodge RD
- Mailing City
- Getzville
- Mailing State
- NY
- Mailing ZIP Code
- 14068-1205
- Mailing Country
- US
- Mailing Phone
- (716) 831-2700
- Practice Street Address
- 100 Niagara St
- Practice City
- Tonawanda
- Practice State
- NY
- Practice ZIP Code
- 14150-1104
- Practice Country
- US
- Practice Phone
- (716) 831-1850
- Enumeration Date
- June 06, 2022
- Last Updated
- January 27, 2025
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 27, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Mental Health Counselor (101YM0800X)