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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. LISA MARIA RUSSO, RD

Active Sole Proprietor

Pediatric Nutrition · ELIZABETH, NJ

Registration Details

NPI Number
1831245687
Provider Type
Individual
Gender
Female
NPI Issued
Jan 26, 2007 (19.235725507391 yrs)
Last Updated
Jan 31, 2014
License
952153 (NJ)
Sole Proprietor
Yes

Practice Information

Address
216 PALMER ST
ELIZABETH, NJ, 072025900
Browse NJ providers · Browse ZIP 07202
Phone
9083530500
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.