Active NPI
Denise Russo, MSIS, MA, CCC-SLP
- Speech-Language Pathologist
- Troy, NY
National Provider Identifier
1942391024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 008494
- Practice address
- 103 Delaware Ave
Troy, NY 12180-5403 - Phone
- (516) 491-8073
- Fax
- (516) 491-8073
- NPI assigned
- Sep 27, 2006
- Last updated
- Jun 6, 2024
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 008494 | NY | Primary |
Addresses
Primary practice location
103 Delaware Ave
Troy, NY 12180-5403
Mailing address
103 Delaware Ave
Troy, NY 12180-5403
Phone (516) 491-8073
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008494 | NY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prentgraf LTD | Speech-Language Pathologist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1942391024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 DELAWARE AVE",
"city": "TROY",
"state": "NY",
"postal_code": "121805403",
"telephone_number": "516-491-8073",
"fax_number": "516-491-8073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 DELAWARE AVE",
"city": "TROY",
"state": "NY",
"postal_code": "121805403",
"telephone_number": "516-491-8073",
"fax_number": "516-491-8073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "DENISE",
"credential": "MSIS, MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2024-06-06",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "008494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.