Active NPI
Cynthia Russell, RPAC
- Medical Physician Assistant
- Brooklyn, NY
National Provider Identifier
1447552963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 014487-1
- Practice address
- 129 Saint Nicholas Ave
Brooklyn, NY 11237-4039 - Phone
- (718) 821-0643
- Fax
- (718) 628-4123
- NPI assigned
- Dec 4, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 014487-1 | NY | Primary |
Addresses
Primary practice location
129 Saint Nicholas Ave
Brooklyn, NY 11237-4039
Mailing address
6449 Austin St
Rego Park, NY 11374-4053
Phone (801) 458-7724
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014487-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291420800000",
"number": "1447552963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6449 AUSTIN ST",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744053",
"telephone_number": "801-458-7724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 SAINT NICHOLAS AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112374039",
"telephone_number": "718-821-0643",
"fax_number": "718-628-4123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "CYNTHIA",
"name_prefix": "Mrs.",
"credential": "RPAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-04",
"last_updated": "2010-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "014487-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.