Jenny Marie Russo, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

343495 Issued in NY

Practice address

9407 156TH Ave Ste 200
Howard Beach, NY 11414-2826

Phone

(718) 323-3773

Fax

(718) 323-3777

NPI assigned

Aug 15, 2018

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

Other names 1

• Jenny Marie Serven Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1639659170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9407 156TH AVE STE 200",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142826",
            "telephone_number": "718-323-3773",
            "fax_number": "718-323-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9407 156TH AVE STE 200",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142826",
            "telephone_number": "718-323-3773",
            "fax_number": "718-323-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JENNY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "SERVEN",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keri Roula
• Ansu Mariam Roy, FNP
• Dina Rozenbaum, MA., CCC-SLP
• Suzanne Jill Rubenstein, D.M.D.
• Joy Elyse Rumack
• Kusmatie S Sakhai, RN
• Adeliz Sanchez
• Maria Sanchez
• Marilena Sausa, OTR/L
• Michelle Kristen Savelli, MSOTR/L

• Family Nurse Practitioner in Howard Beach, NY
• Providers in Howard Beach, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.