Kateryna Russo, LMT

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

007128 Issued in NY

Practice address

160 Old Country Rd
Riverhead, NY 11901-2198

Phone

(516) 796-2400

NPI assigned

Jul 25, 2022

Last updated

Jul 25, 2022By the provider in NPPES

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1275269177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DUPONT ST STE 110",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031606",
            "telephone_number": "516-796-2400",
            "fax_number": "516-796-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 OLD COUNTRY RD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012198",
            "telephone_number": "516-796-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6144 Route 25A",
            "address_2": "Wading River",
            "address_purpose": "LOCATION",
            "city": "NY",
            "state": "NY",
            "postal_code": "117922018",
            "country_code": "US",
            "telephone_number": "516-796-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "KATERYNA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "007128",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "030831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.

Verify at the official NPI Registry.