National Provider Identifier
Randi Ruth Larussa, PHYSICIAN ASSISTANT
Randi Ruth Larussa, PHYSICIAN ASSISTANT is listed in the NPPES registry with a primary specialty of Physician Assistant in Rochester, NY and a listed phone number of (585) 760-5466.
Profile Overview
- NPI
- 1699858258
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- October 24, 2006
- Last Updated
- September 10, 2014
Practice Location
- 435 E Henrietta RD
- Rochester, NY 14620-4629
Phone: (585) 760-5466
Mailing Address
- 100 St Camillus Way
- Fairport, NY 14450
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1699858258
- Entity Type
- Individual
- Last Name
- Larussa
- First Name
- Randi
- Middle Name
- Ruth
- Name Prefix
- Mrs.
- Credential
- PHYSICIAN ASSISTANT
- Mailing Street Address
- 100 St Camillus Way
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450
- Mailing Country
- US
- Mailing Phone
- (585) 377-4000
- Mailing Fax
- (585) 377-0013
- Practice Street Address
- 435 E Henrietta RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-4629
- Practice Country
- US
- Practice Phone
- (585) 760-5466
- Practice Fax
- (585) 760-5467
- Enumeration Date
- October 24, 2006
- Last Updated
- September 10, 2014
- Sex
- Female
- Sole Proprietor
- No
- Taxonomies
- Physician Assistant (363A00000X)