Individual
MS. ELIZABETH RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
71 KENDALL ST, CLIFTON SPRINGS, NY 14432
(315) 462-0447
(315) 462-3891
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-0553
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
499435-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F303057-1
NY
Other
Enumeration date
01/02/2014
Last updated
09/25/2019
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