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Individual

MS. CHERYL RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
20 OLD TURNPIKE RD, NANUET, NY 10954-2532
(845) 624-0260
Mailing address
200 AVENUE G, MATAMORAS, PA 18336-1212
(845) 313-8570

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329522-1
NY

Other

Enumeration date
08/18/2017
Last updated
08/18/2017
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