Active NPI
Marni Russo, PSYD, NCSP
- Psychologist
- New York, NY
National Provider Identifier
1043616923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 024661
- Practice address
- 185 Madison Ave FL 14
New York, NY 10016-4325 - Phone
- (212) 506-5935
- NPI assigned
- Nov 5, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 024661 | NY | Primary |
Addresses
Primary practice location
185 Madison Ave FL 14
New York, NY 10016-4325
Mailing address
303 5TH Ave RM 502
New York, NY 10016-6644
Phone (917) 791-0525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024661 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663200000000",
"number": "1043616923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 5TH AVE RM 502",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100166644",
"telephone_number": "917-791-0525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 MADISON AVE FL 14",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100164325",
"telephone_number": "212-506-5935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "MARNI",
"credential": "PSYD, NCSP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-05",
"last_updated": "2022-09-15",
"certification_date": "2022-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "024661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.