Individual provider · Type 1 NPI
Christine Elizabeth Russo, CPNP-PC
Pediatric Nurse Practitioner · Stony Brook, NY
NPI number
1720738263
Active
Practice location
101 Nicolls Rd
Stony Brook, NY 11794-0001
Mailing address
136 Windward Dr
Port Jefferson, NY 11777-2331
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 383362 (NY) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1720738263
Christine Elizabeth Russo, CPNP-PC's National Provider Identifier is 1720738263, issued on Mar 27, 2022. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Stony Brook, NY. The record was last updated on Mar 27, 2022.