National Provider Identifier
Angel M. Russo, PHD
Angel M. Russo, PHD is listed in the NPPES registry with a primary specialty of Clinical Psychologist in Orchard Park, NY and a listed phone number of (716) 667-7031.
Profile Overview
- NPI
- 1457376543
- Provider Type
- Individual
- Primary Specialty
- Clinical Psychologist
- Enumeration Date
- July 12, 2006
- Last Updated
- December 05, 2011
Practice Location
- 6541 Webster RD
- Orchard Park, NY 14127-1920
Phone: (716) 667-7031
Specialties
- Clinical Psychologist (103TC0700X)
Full Record
- NPI
- 1457376543
- Entity Type
- Individual
- Last Name
- Russo
- First Name
- Angel
- Middle Name
- M.
- Credential
- PHD
- Mailing Street Address
- 6541 Webster RD
- Mailing City
- Orchard Park
- Mailing State
- NY
- Mailing ZIP Code
- 14127-1920
- Mailing Country
- US
- Mailing Phone
- (716) 667-7031
- Mailing Fax
- (716) 667-7034
- Practice Street Address
- 6541 Webster RD
- Practice City
- Orchard Park
- Practice State
- NY
- Practice ZIP Code
- 14127-1920
- Practice Country
- US
- Practice Phone
- (716) 667-7031
- Practice Fax
- (716) 667-7034
- Enumeration Date
- July 12, 2006
- Last Updated
- December 05, 2011
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Psychologist (103TC0700X)
- Other Identifiers
- 000511671007 (NY, Blue Cross & Blue Shield), 6105576 (NM, Independent Health), 00020246901 (NY, Univera)