Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY RUSSO
ActivePediatric Nutrition · ROCHESTER, NY
Registration Details
- NPI Number
- 1275495855
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 2, 2025 (0.3972535614648 yrs)
- Last Updated
- Feb 6, 2026
- License
-
917553 (NY)
Practice Information
- Address
-
601 ELMWOOD AVEROCHESTER, NY, 146420001Browse NY providers · Browse ZIP 14642
- Phone
- 5852752647
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
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.