Individual
TAMMY J RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NPP
Contact information
Practice address
2141 EASTERN PKWY, NISKAYUNA, NY 12309-6343
(518) 518-8172
(518) 982-1277
Mailing address
2141 EASTERN PKWY, NISKAYUNA, NY 12309-6343
(518) 982-1274
(518) 982-1277
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401129-01
NY
Other
Enumeration date
06/23/2008
Last updated
09/28/2022
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