National Provider Identifier
Kaitlyn Russo
Kaitlyn Russo is listed in the NPPES registry with a primary specialty of Physical Therapist in Kenmore, NY and a listed phone number of (716) 874-6175.
Profile Overview
- NPI
- 1598139107
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- November 19, 2015
- Last Updated
- November 19, 2015
Practice Location
- 3767 Delaware Ave
- Kenmore, NY 14217-1040
Phone: (716) 874-6175
Mailing Address
- 178 School St
- Kenmore, NY 14217-1134
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1598139107
- Entity Type
- Individual
- Last Name
- Russo
- First Name
- Kaitlyn
- Mailing Street Address
- 178 School St
- Mailing City
- Kenmore
- Mailing State
- NY
- Mailing ZIP Code
- 14217-1134
- Mailing Country
- US
- Practice Street Address
- 3767 Delaware Ave
- Practice City
- Kenmore
- Practice State
- NY
- Practice ZIP Code
- 14217-1040
- Practice Country
- US
- Practice Phone
- (716) 874-6175
- Enumeration Date
- November 19, 2015
- Last Updated
- November 19, 2015
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)