Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. RUSSELL JOHN RIDULFO, PA
Active Sole ProprietorPhysician Assistant · NESCONSET, NY
Registration Details
- NPI Number
- 1407697683
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 3, 2024 (1.9094440877393 yrs)
- Last Updated
- Jun 3, 2024
- Sole Proprietor
- Yes
Practice Information
- Address
-
12 MAPLE GLEN LNNESCONSET, NY, 117671712Browse NY providers · Browse ZIP 11767
- Phone
- 6319420295
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in NESCONSET, NY
| Name | Credential | NPI |
|---|---|---|
| RHONDA R EDWARDS-BRAITHWAITE | PA | 1184714206 |
| MISS CINDY A CALLAHAN | RPA-C | 1013162510 |
| RANDI RASBERRY | PA-C | 1215313903 |
| FAIZA R SHAH | PA | 1922669886 |
| PAIGE SUZANNE KARRAS | PA-C | 1003520784 |
| NEHA CHOWDHURY | PA | 1770475428 |
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.