NICOLE RUSSO (NPI# 1235647314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235647314 |
| Entity Type | Individual |
| Full Name | NICOLE RUSSO |
| Practice Address |
9815 Roosevelt Blvd Philadelphia PA 19114-1035 |
| Mailing Address |
680 American Ave King of Prussia PA 19406-4023 |
| Practice Telephone | 6166446464 |
| Mailing Telephone | 6166446464 |
| Mailing Fax Number | 6109816078 |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902411630 | Nicole Russo | Social Worker | 398 W Bagley Rd Ste 13, Berea, OH 44017-1312 | 2020-09-10 |
| 1093152720 | Nicole Elizabeth Russo | Dentist | 231 W Esplanade Ave Ste A, Kenner, LA 70065-2459 | 2013-06-04 |
| 1356572747 | Nicole Russo | Massage Therapist | 38 Montvale Ave Ste 330, Stoneham, MA 02180-2450 | 2009-08-03 |
| 1710921234 | Nicole Z Russo | Speech-Language Pathologist | 577 Blue Cypress Dr, Groveland, FL 34736-8111 | 2006-06-15 |
| 1326528522 | Nicole Lorraine Russo | Case Manager/Care Coordinator | 2001 The Alameda, San Jose, CA 95126-1136 | 2018-08-16 |
| 1699295469 | Nicole Ann Russo | Occupational Therapist | 6575 Kirkville Rd, East Syracuse, NY 13057-9809 | 2017-06-22 |
| 1962810317 | Nicole Brooke Russo | Pharmacist | 2754 Hylan Blvd, Staten Island, NY 10306-4658 | 2014-07-30 |
| 1013337864 | Nicole Russo | Physical Therapist | 2123 Highway 35, Sea Girt, NJ 08750-1003 | 2014-04-21 |
| 1992133490 | Nicole Russo | Counselor | 715 Sw Ramsey Ave, Grants Pass, OR 97527-5500 | 2013-10-18 |
| 1841557394 | Nicole Russo | Counselor | 19 Union Sq W, 7th Floor, New York, NY 10003-3304 | 2012-04-20 |
| Street Address |
9815 ROOSEVELT BLVD |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19114-1035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548203839 | Uplekh Purewal | Anesthesiology | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1011 | 2006-06-14 |
| 1144797689 | Christina Groves | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-11-01 |
| 1346723962 | Alexander Jaffe | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-09-10 |
| 1881172310 | Allan Terciano | Physical Therapist | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-08-06 |
| 1043705098 | Lily Dunlap | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-06-22 |
| 1952804817 | Jessica Lyman | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-03-16 |
| 1316488315 | Maxim Healthcare Services Inc | Home Health | 9815 Roosevelt Blvd, Unit E, Philadelphia, PA 19114-1035 | 2017-03-10 |
| 1942663950 | Jason Horrox | Physical Therapist | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2016-03-29 |
| 1528428075 | Gina Cardillo | Counselor | 9815 Roosevelt Blvd, Suite B, Philadelphia, PA 19114-1035 | 2016-02-26 |
| 1558736769 | Jeanimarie Goodwin | Counselor | 9815 Roosevelt Blvd, Suite B, Philadelphia, PA 19114-1035 | 2015-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029906 | Phuoc Nguyen | Nurse Anesthetist, Certified Registered | Jefferson Torresdale Hospital, 10800 Knights Rd, Philadelphia, PA 19114 | 2020-10-05 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1215419080 | Thomas Patrick Gallagher | Specialist/Technologist | 2708 Ruth Way, Philadelphia, PA 19114 | 2018-08-29 |
| 1558840223 | Alexis Wenger | Early Intervention Provider Agency | 3810 Aubrey Ave, Phila, PA 19114 | 2018-08-13 |
| 1245759232 | Newlands Health | Clinic/Center | 9625 Frankford Ave., Philadelphia, PA 19114 | 2017-09-12 |
| 1619491453 | Nazareth Physician Services Inc | Social Worker | 9815 Roosevelt Blvd Ste G, Philadelphia, PA 19114 | 2017-08-02 |
| 1326561606 | L.s. Share & Love Support Coordinating Agency, LLC | Case Management | 3600 Red Lion Road, Apt 68c, Philadelphia, PA 19114 | 2017-07-19 |
| 1760911952 | Charles C Richards II | Counselor | 2555 Welsh Rd, Apt 407, Philadelphia, PA 19114 | 2017-06-09 |
| 1801338686 | April Neuls | Physical Therapy Assistant | 4213 Lackland Place, Philadelphia, PA 19114 | 2016-11-10 |
| 1114317583 | Siji Cyriac | Physical Therapist | 9501 State Road, Philadelphia, PA 19114 | 2015-01-23 |
| Find all providers in zip 19114 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386269231 | Rasheeda Jackson | Counselor | 117 Rosemar St, Philadelphia, PA 19120-1922 | 2020-06-16 |
| 1275170763 | Erika Anaya Kellogg | Counselor | 3535 Market St Dept Of, Philadelphia, PA 19104-3309 | 2019-12-04 |
| 1568008480 | Heather Mcgee | Counselor | 3343 Bowman St, Philadelphia, PA 19129-1538 | 2019-11-26 |
| 1104468222 | Johann Ochoa | Counselor | 3900 Woodland Ave Bldg 3, Philadelphia, PA 19104-4551 | 2019-10-09 |
| 1730735051 | Jill Verofsky | Counselor | 1180 Jfk Blvd, Suite 1110, Philadelphia, PA 19103 | 2019-08-13 |
| 1447805114 | Sobriety Now LLC. | Counselor | 100 S Broad St Ste 2230, Philadelphia, PA 19110-1021 | 2019-08-08 |
| 1811453558 | Terence Jones | Counselor | 1200 Callowhill St., Suite 101, Philadelphia, PA 19123 | 2019-02-19 |
| 1215400106 | David Francis Ross Sr. | Counselor | 622 W Chew Ave Ste 2, Philadelphia, PA 19120-2211 | 2019-01-03 |
| 1124502604 | Saida Heywood | Counselor | 1306 Catharine St, Philadelphia, PA 19147-2628 | 2018-09-20 |
| 1437649415 | Ashley Przywitowski | Counselor | 9815 Roosevelt Blvd Ste B, Philadelphia, PA 19114-1035 | 2018-05-15 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19114 |
Please comment or provide details below to improve the information on NICOLE RUSSO.
| 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.