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
- 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 and National Provider Directory roles.
-
- Speech-Language Pathologist
- Princeton, NJ
- NPI 1376180679
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.