NICOLE BROOKE RUSSO (NPI# 1962810317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962810317 |
| Entity Type | Individual |
| Full Name | NICOLE BROOKE RUSSO |
| Credential | PHARMD, RPH |
| Practice Address |
2754 Hylan Blvd Staten Island NY 10306-4658 |
| Mailing Address |
1058 Sheldon Ave Staten Island NY 10309-2115 |
| Practice Telephone | 7189802059 |
| Mailing Telephone | 7188254645 |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2014-07-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 059546 | NY | Pharmacy 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 |
| 1235647314 | Nicole Russo | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-01-11 |
| 1699295469 | Nicole Ann Russo | Occupational Therapist | 6575 Kirkville Rd, East Syracuse, NY 13057-9809 | 2017-06-22 |
| 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 |
2754 HYLAN BLVD |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10306-4658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487686341 | Stop and Shop Supermarket Co LLC | Durable Medical Equipment & Medical Supplies | 2754 Hylan Blvd, Staten Island, NY 10306-4658 | 2006-07-07 |
| 1801251756 | Seung Gwan Lee | Pharmacist | 2754 Hylan Blvd, Staten Island, NY 10306-4658 | 2015-12-19 |
| 1790017465 | John Zoldak | Pharmacist | 2754 Hylan Blvd, Staten Island, NY 10306-4658 | 2010-02-05 |
| 1093965642 | Barbara J Barghaan | Pharmacist | 2754 Hylan Blvd, Staten Island, NY 10306-4658 | 2008-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134737372 | Nancy Burns | Counselor | 345 Guyon Ave # 14, Staten Island, NY 10306 | 2020-07-14 |
| 1710537642 | Happy Island Senior Center LLC | Clinic/Center | 555 Greeley Ave, Staten Island, NY 10306 | 2019-09-12 |
| 1215580055 | Keann Pender | Counselor | 345 Guyon Ave Rm 14, Staten Island, NY 10306 | 2019-07-22 |
| 1346751435 | Amanda Nicole Lewis | Speech-Language Pathologist | 465 New Dorp Lane, The Richard H. Hungerford School, Staten Island, NY 10306 | 2017-10-17 |
| 1649793142 | Olympia Services Inc | Radiology | 1913 Olympia Blvd., Staten Island, NY 10306 | 2017-07-18 |
| 1265961601 | A & S Educational Technology Inc. | Early Intervention Provider Agency | 99 Sydney Pl, Staten Island, NY 10306 | 2017-06-08 |
| 1124489638 | Prospect Kids, LLC | Early Intervention Provider Agency | 21 Kayla Court, Staten Island, NY 10306 | 2016-03-10 |
| 1124498407 | Tatyana Kateva | Registered Nurse | 1975 Hylan Blvd Suite 1, Staten Island, NY 10306 | 2015-09-30 |
| 1336536275 | Natallia Verbitsky | Occupational Therapist | 165 Twombly Ave, Staten Island, NY 10306 | 2015-04-17 |
| 1922491745 | Evan Ross Cohen | Dentist | 1975 Hylan Blvd., Unit #2, Hylan Dental Arts, Staten Island, NY 10306 | 2015-03-18 |
| Find all providers in zip 10306 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220370 | Minamark M Nageib | Pharmacist | 72 Bridgetown St, Staten Island, NY 10314-6204 | 2020-09-22 |
| 1912513805 | Zakaria Amin | Pharmacist | 382 Ridgewood Ave, Staten Island, NY 10312-2118 | 2020-09-17 |
| 1073136065 | Matthew Thomas Tilatitsky | Pharmacist | 103 Sprague Ave, Staten Island, NY 10307-1931 | 2020-05-25 |
| 1255967220 | Peter J Delorenzo | Pharmacist | 123 Oxford Pl, Staten Island, NY 10301-3016 | 2020-03-21 |
| 1710525514 | Ira Bace | Pharmacist | 146 Freedom Ave, Staten Island, NY 10314-3706 | 2019-12-12 |
| 1760026983 | Hassan Gihad Hamouche | Pharmacist | 213 Norway Ave, Staten Island, NY 10305-3522 | 2019-10-30 |
| 1730722448 | Daniel Nabil Girgis | Pharmacist | 177 Sandalwood Dr, Staten Island, NY 10308-1863 | 2019-10-25 |
| 1437714300 | Miriam Lyubina | Pharmacist | 29 Star Ct, Staten Island, NY 10312-2448 | 2019-05-07 |
| 1134686173 | Muhammad Usman | Pharmacist | 928 Rockland Ave Apt 2, Staten Island, NY 10314-7706 | 2019-02-26 |
| 1831660786 | Amir I Yaqoob | Pharmacist | 92 Slater Blvd, Staten Island, NY 10305-2106 | 2018-12-17 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10306 |
Please comment or provide details below to improve the information on NICOLE BROOKE 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.