Russell L Maiese, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

036583 Issued in CT

Practice address

1 Greenwich PL
Shelton, CT 06484-4618

Phone

(866) 436-9631

Fax

(203) 929-2344

NPI assigned

Jan 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ameripath New York LLC

  • Clinical Medical Laboratory
  • White Plains, NY
  • NPI 1043282841
  NPD (past)
• Ameripath New York LLC

  • Clinical Medical Laboratory
  • Mount Kisco, NY
  • NPI 1962223370
  NPD (past)
• Kilpatrick Pathology PA

  • Clinical Medical Laboratory
  • King, NC
  • NPI 1124035316
  NPD (past)

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1093794356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD",
            "address_2": "SUITE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "866-436-9631",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GREENWICH PL",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844618",
            "telephone_number": "866-436-9631",
            "fax_number": "203-929-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIESE",
        "first_name": "RUSSELL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CT",
            "license": "036583",
            "primary": true
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "CT",
            "license": "036583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanae Monique Lynch, LCSW
• Kaitlyn A Lyver, PA-C
• Joseph S. Madrak, O.D.
• Carla Maffeo-Mitchell, M.D.
• Kristen H Magner, PA-C
• Angela Maione Seznec
• Youseph Makkawi
• Krizia Malave Guzman, M.D.
• Kathleen A Maloney, ST
• Nino Mamukashvili

• Anatomic Pathology & Clinical Pathology Physician in Shelton, CT
• Providers in Shelton, CT by specialty
• Anatomic Pathology & Clinical Pathology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.