Warren Russell

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

267490-1 Issued in NY

Practice address

284 S Columbus Ave
PH
Mount Vernon, NY 10553-1537

Phone

(347) 219-4050

NPI assigned

Aug 20, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1154637718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 S COLUMBUS AVE",
            "address_2": "PH",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531537",
            "telephone_number": "347-219-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 S COLUMBUS AVE",
            "address_2": "PH",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531537",
            "telephone_number": "347-219-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "WARREN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "267490-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Ann Ruffin, COTA/L
• Danielle A Ruocco, D.D.S.
• Audria Ann-Marie Russell
• Robert Alan Russell, D.C.
• Rosemarie Russell, FNP
• Angela Russo
• Rvohrx, LLC
• S&a Drug Store Inc
• Patricia Anne Sadriyoun
• Drew Yates Sagar, NP

• Licensed Practical Nurse in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.