Individual
MARNI RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, NCSP
Contact information
Practice address
185 MADISON AVE FL 14, NEW YORK, NY 10016-4325
(212) 506-5935
Mailing address
303 5TH AVE RM 502, NEW YORK, NY 10016-6644
(917) 791-0525
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
024661
NY
Other
Enumeration date
11/05/2014
Last updated
09/15/2022
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