Individual
CHRISTINE ELIZABETH RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 682-3289
Mailing address
136 WINDWARD DR, PORT JEFFERSON, NY 11777-2331
(631) 682-3289
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
383362
NY
Other
Enumeration date
03/27/2022
Last updated
03/27/2022
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