Patricia Russo, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000855 Issued in PA

Practice address

703 Rutter Ave
Kingston, PA 18704-4801

Phone

(570) 288-7405

Fax

(570) 288-7406

NPI assigned

Mar 23, 2006

Last updated

Feb 21, 2014By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1356301535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "570-288-7405",
            "fax_number": "570-288-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 RUTTER AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044801",
            "telephone_number": "570-288-7405",
            "fax_number": "570-288-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "PATRICIA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1434981",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard E Roth, DO
• Diana Ruhf
• Kristyn Ruhf
• Jennifer Runquist
• John Wesley Rusen, MASSAGE THERAPIST
• Bruce H Saidman, MD
• Samour Medical, P.C. (Samour Medical)
• Sanjeev Garg LLC
• Daniel Joseph Saporito, DPM
• Scott Sauerwine, MD

• Optometrist in Kingston, PA
• Providers in Kingston, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; 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.