DR. RUSSELL L MAIESE (NPI# 1093794356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093794356 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL L MAIESE |
| Credential | MD |
| Practice Address |
1 Greenwich Pl Shelton CT 06484-4618 |
| Mailing Address |
14275 Midway Rd Suite 400 Addison TX 75001-3614 |
| Practice Telephone | 8664369631 |
| Practice Fax Number | 2039292344 |
| Mailing Telephone | 8664369631 |
| Mailing Fax Number | 6102714245 |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2015-05-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZH0000X |
Pathology Specialization: Hematology |
036583 | CT | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
036583 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
1 GREENWICH PL |
| City | SHELTON |
| State | CT |
| Zip Code | 06484-4618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295714632 | Alexander B West | Pathology | 1 Greenwich Pl, Shelton, CT 06484-4618 | 2006-01-13 |
| 1396386777 | Daniel Di Bartolo | Pathology | 1 Greenwich Pl, Shelton, CT 06484-7603 | 2019-10-07 |
| 1962757591 | Connecticut Orthopaedic Specialists, PC | Occupational Therapist | 1 Greenwich Pl, 889 Bridgeport Ave, Shelton, CT 06484-7603 | 2012-07-19 |
| 1134486848 | Xia Li | Medical Genetics, Ph.D. Medical Genetics | 1 Greenwich Pl, Shelton, CT 06484-7603 | 2012-04-19 |
| 1942539325 | Steven L Gersen | Medical Genetics, Ph.D. Medical Genetics | 1 Greenwich Pl, Shelton, CT 06484-7603 | 2009-12-15 |
| 1194966168 | Kamraan Zafar Gill | Pathology | 1 Greenwich Pl, Shelton, CT 06484-7603 | 2009-03-20 |
| 1730374570 | Philip M Prior | Physical Therapist | 1 Greenwich Pl, Shelton, CT 06484-7603 | 2007-09-13 |
| 1356470710 | Gerald Patrick Bailey | Pathology | 1 Greenwich Pl, Shelton, CT 06484-4618 | 2007-03-03 |
| 1134210099 | Linda Trapkin | Pathology | 1 Greenwich Pl, Shelton, CT 06484-7603 | 2006-09-27 |
| 1194797993 | Ameripath New York LLC | Clinical Medical Laboratory | 1 Greenwich Pl, Shelton, CT 06484-4618 | 2006-02-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949517 | Judy Ports | Speech-Language Pathologist | 100 Bear Sawmill Rd, Shelton, CT 06484 | 2020-07-22 |
| 1144793340 | Theodore N. Zengou | Pharmacist | 875 Bridgeport Av., Shelton, CT 06484 | 2019-01-10 |
| 1194215046 | Brightview Shelton LLC | Alzheimer Center (Dementia Center) | 30 Beard Sawmill Road, Shelton, CT 06484 | 2018-05-16 |
| 1477071264 | Emily Buccigross | Specialist/Technologist | 941 Constitution Blvd N, Shelton, CT 06484 | 2017-09-01 |
| 1134649643 | Margaret Grace Ferrara | Dentist | 4 Corporate Dr Ste 383, Shelton, CT 06484 | 2017-06-26 |
| 1376092007 | Qmg3 LLC | Family Medicine | 405 Bridgeport Avenue, Shelton, CT 06484 | 2016-09-22 |
| 1215316427 | Marcella N. Sancho, Lcsw, LLC | Social Worker | 4 Research Drive, Suite 402, Shelton, CT 06484 | 2015-05-20 |
| 1578987483 | Lisa Sych | Speech-Language Pathologist | 584 Long Hill Avenue- Bishop Wicke Health Center, Shelton, CT 06484 | 2014-02-12 |
| 1073936324 | Jeanne M. Kellogg | Occupational Therapy Assistant | 36 Fairlane Dr., Shelton, CT 06484 | 2014-01-22 |
| 1851724454 | Brittany Steiner | Behavioral Analyst | 26 Pound Ridge Ave, Shelton, CT 06484 | 2013-08-19 |
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| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134121064 | Fabiola Sara Balarezo | Pathology | 2 Trap Falls Road, Suite 414, Shelton, CT 06484-7354 | 2005-08-11 |
| 1659404481 | Gary Scott Tennyson | Pathology | 1 Forest Pkwy, Shelton, CT 06484-6147 | 2007-03-13 |
| 1134210099 | Linda Trapkin | Pathology | 1 Greenwich Pl, Shelton, CT 06484-7603 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730625856 | Karen Blomquist | Pathology | 43 Essex Ln, Woodbury, CT 06798-2631 | 2017-01-12 |
| 1508244070 | Pallavi Patil | Pathology | 20 York St # Ep2-612, New Haven, CT 06510-3220 | 2015-05-15 |
| 1477968261 | Chen Yang | Pathology | 310 Cedar St # Lh108, New Haven, CT 06510 | 2014-06-30 |
| 1023436029 | Physicians for Women's Health, LLC | Pathology | 22 Waterville Rd, Avon, CT 06001-2066 | 2014-04-07 |
| 1295077790 | Gordon Seth Cohen | Pathology | 3 Silo Hill Road, Madison, CT 06443 | 2013-03-22 |
| 1841557949 | Lewis Morton Portnoy | Pathology | 10 Linda Ln, Westport, CT 06880-3945 | 2012-04-13 |
| 1730475963 | Patricia Marie Raciti | Pathology | Greenwich Hospital, 5 Perryridge Road, Greenwich, CT 06830 | 2011-06-27 |
| 1538452594 | Lois Wurzel | Pathology | 77 Bayberry Hill Rd, Avon, CT 06001-2800 | 2011-05-24 |
| 1134377344 | Andrew Stuart Radow | Pathology | 16 Lawton Dr, Simsbury, CT 06070-2725 | 2008-08-29 |
| 1699937748 | Heather Mary Carney | Pathology | 2800 Main, Dept. of Pathology, Bridgeport, CT 06606-4201 | 2008-06-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.