National Provider Identifier
Mary R Russo, RN
Mary R Russo, RN is listed in the NPPES registry with a primary specialty of Registered Nurse in Ithaca, NY and a listed phone number of (607) 277-3415.
Profile Overview
- NPI
- 1962703587
- Provider Type
- Individual
- Primary Specialty
- Registered Nurse
- Enumeration Date
- November 12, 2010
- Last Updated
- February 17, 2014
Practice Location
- 603 Willow Ave
- Ithaca, NY 14850-3555
Phone: (607) 277-3415
Mailing Address
- 603 Willow Ave
- Ithaca, NY 14850-5635
Specialties
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1962703587
- Entity Type
- Individual
- Last Name
- Russo
- First Name
- Mary
- Middle Name
- R
- Name Prefix
- MS.
- Credential
- RN
- Mailing Street Address
- 603 Willow Ave
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-5635
- Mailing Country
- US
- Mailing Phone
- (607) 277-3415
- Mailing Fax
- (607) 277-3415
- Practice Street Address
- 603 Willow Ave
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-3555
- Practice Country
- US
- Practice Phone
- (607) 277-3415
- Enumeration Date
- November 12, 2010
- Last Updated
- February 17, 2014
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Nurse (163W00000X)