Individual
MELISSA ANN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
239 MIDDLE COUNTRY RD, SELDEN, NY 11784-2516
(631) 696-5437
Mailing address
27 CATHERINE DR, SELDEN, NY 11784-1801
(631) 662-6127
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
606997-1
NY
Other
Enumeration date
03/13/2021
Last updated
03/13/2021
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