Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARY RUSSO
Active Sole ProprietorPediatric Nutrition · SYRACUSE, NY
Registration Details
- NPI Number
- 1205922382
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 5, 2006 (19.556145054327 yrs)
- Last Updated
- Jul 8, 2007
- License
-
002593-1 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
750 E ADAMS STSYRACUSE, NY, 132102306Browse NY providers · Browse ZIP 13210
- Phone
- 3154644220
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Other Pediatric Nutrition Providers in SYRACUSE, NY
| Name | Credential | NPI |
|---|---|---|
| STACEY L MESSE | RD, CDN, CNSC | 1760874150 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.