National Provider Identifier

Kelly Russo

Kelly Russo is listed in the NPPES registry with a primary specialty of Pediatric Nutrition Registered Dietitian in Rochester, NY and a listed phone number of (585) 275-2647.

NPI 1275495855Rochester, NYPediatric Nutrition Registered Dietitian

Profile Overview

NPI
1275495855
Provider Type
Individual
Primary Specialty
Pediatric Nutrition Registered Dietitian
Enumeration Date
December 02, 2025
Last Updated
February 06, 2026

Practice Location

  • 601 Elmwood Ave
  • Rochester, NY 14642-0001

Phone: (585) 275-2647

Mailing Address

  • 783 Middlebury RD
  • Webster, NY 14580-2681

Specialties

  • Pediatric Nutrition Registered Dietitian (133VN1004X)
Full Record
NPI
1275495855
Entity Type
Individual
Last Name
Russo
First Name
Kelly
Mailing Street Address
783 Middlebury RD
Mailing City
Webster
Mailing State
NY
Mailing ZIP Code
14580-2681
Mailing Country
US
Practice Street Address
601 Elmwood Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14642-0001
Practice Country
US
Practice Phone
(585) 275-2647
Enumeration Date
December 02, 2025
Last Updated
February 06, 2026
Sex
Female
Sole Proprietor
No
Certification Date
February 06, 2026
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pediatric Nutrition Registered Dietitian (133VN1004X)