Individual
MRS. AMANDA D RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
283 ADAMS ST, BROOKLYN, NY 11201
(718) 858-1160
Mailing address
1235 N RAILROAD AVE, STATEN ISLAND, NY 10306
(718) 309-2035
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
023644
NY
Other
Enumeration date
04/10/2014
Last updated
07/21/2022
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