Active NPI
Amanda B Russo, D.C.
- Chiropractor
- Sayville, NY
National Provider Identifier
1881999779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X011982-1
- Practice address
- 285 Terry Rd
Sayville, NY 11782-3343 - Phone
- (631) 563-2225
- NPI assigned
- Jan 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X011982-1 | NY | Primary |
Addresses
Primary practice location
285 Terry Rd
Sayville, NY 11782-3343
Mailing address
285 Terry Rd
Sayville, NY 11782-3343
Phone (631) 563-2225
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011982 | NY | MD | Mental Health Counselor |
| X011982-1 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1881999779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 TERRY RD",
"city": "SAYVILLE",
"state": "NY",
"postal_code": "117823343",
"telephone_number": "631-563-2225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 TERRY RD",
"city": "SAYVILLE",
"state": "NY",
"postal_code": "117823343",
"telephone_number": "631-563-2225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "AMANDA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-24",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X011982-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sayville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.