Maria Theresa Russo, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

010078 Issued in NY

Practice address

7 Wildflower Lane
East Hampton, NY 11937-0254

Phone

(631) 329-3185

Fax

(631) 907-0726

NPI assigned

Mar 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Specialty

Clinical Psychologist

Education

New York University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558490466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4062",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119370254",
            "telephone_number": "631-329-3185",
            "fax_number": "631-907-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WILDFLOWER LANE",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119370254",
            "telephone_number": "631-329-3185",
            "fax_number": "631-907-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "MARIA",
        "middle_name": "THERESA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "010078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Thomas Romano, PHARM D.
• Dora Clemencia Romero, LMSW
• Tanya Maria Rosen, LMHC, CASAC
• Helene Debra Rosenberg, M.A., CCC-SLP
• Rosalie J Rusak, ED.S IN MFT
• Joanne Ryan, NP
• Shannon Ryan, C-FNP
• Nicholas Sabatino, PA
• Safe Harbor Retreat (The Dunes)
• Sammy G. Nakhla, M.D., P.C.

• Clinical Psychologist in East Hampton, NY
• Providers in East Hampton, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.