Individual provider Active NPI

Tami Lynn Russo, L.M.T

  • Specialist
  • Tonawanda, NY
National Provider Identifier
1558548453
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
008343 Issued in NY
Practice address
221 Highland Pkwy
Tonawanda, NY 14223-1407
Phone
(716) 873-6999
NPI assigned
Jan 23, 2008
Last updated
Jan 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 008343 NY Primary

Addresses

Primary practice location

221 Highland Pkwy
Tonawanda, NY 14223-1407

Mailing address

31 Malvern Curv
Tonawanda, NY 14150-8738
Phone (716) 807-9738

Other identifiers 1

IdentifierTypeStateIssuer
008343OtherNYL.M.T.

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

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1558548453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MALVERN CURV",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508738",
            "telephone_number": "716-807-9738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 HIGHLAND PKWY",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "142231407",
            "telephone_number": "716-873-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "TAMI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "L.M.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "008343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L.M.T.",
            "identifier": "008343",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; 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.