Individual provider Active NPI

Elizabeth Frances Russo, RN

  • Registered Nurse
  • Lackawanna, NY
National Provider Identifier
1093072522
Registry record updated Apr 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
602887-1 Issued in NY
Practice address
23 Myers Rd
Lackawanna, NY 14218-2914
Phone
(716) 725-6177
NPI assigned
Apr 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 602887-1 NY Primary

Addresses

Primary practice location

23 Myers Rd
Lackawanna, NY 14218-2914

Mailing address

23 Myers Rd
Lackawanna, NY 14218-2914
Phone (716) 725-6177

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
602887-1NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335052800000",
    "number": "1093072522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MYERS RD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142182914",
            "telephone_number": "716-725-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MYERS RD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142182914",
            "telephone_number": "716-725-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "ELIZABETH",
        "middle_name": "FRANCES",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-22",
        "last_updated": "2012-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "602887-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackawanna, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.