ROBERT D. RUSSO (NPI# 1114924693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114924693 |
| Entity Type | Individual |
| Full Name | ROBERT D. RUSSO |
| Credential | M.D. |
| Practice Address |
75 Kings Highway Cutoff Suite 1a Fairfield CT 06824-5340 |
| Mailing Address |
4695 Main St Suite 5 Bridgeport CT 06606-1802 |
| Practice Telephone | 2038151877 |
| Practice Fax Number | 2035385246 |
| Mailing Telephone | 2035385233 |
| Mailing Fax Number | 2035385246 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2017-03-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
016805 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001168053 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467547703 | Robert Joseph Russo | Dentist | 1929 Lincoln Hwy East, Suite 150, Lancaster, PA 17602 | 2006-10-03 |
| 1831282904 | Robert Edward Russo | Technician/Technologist | 18 Railroad Street, Essex Junction, VT 05453 | 2006-10-02 |
| 1912274978 | Robert Russo | Pharmacist | 1809 E Allegheny Ave, Philadelphia, PA 19134-3119 | 2011-11-18 |
| 1245480045 | Robert Russo Jr. | Counselor | 311 Doric Ave, Cranston, RI 02910-2903 | 2008-09-29 |
| 1740293661 | Robert Russo | Internal Medicine | 301 Industrial Rd, San Carlos, CA 94070-2603 | 2006-08-14 |
| 1891720066 | Robert Anthony Russo | Dentist | 321 Washington St, Gloucester, MA 01930-4837 | 2006-07-12 |
| 1215976493 | Robert Russo Jr. | Physical Therapist | 4266 Acme Rd, Frankfort, NY 13340-3504 | 2006-06-05 |
| 1104871656 | Robert James Russo | Physician Assistant | 1000 Langworthy St, Dubuque, IA 52001-7313 | 2006-05-23 |
| 1881643245 | Robert A Russo | Podiatrist | 1255 Portland Ave, Rochester, NY 14621-2728 | 2006-05-10 |
| 1730144064 | Robert J. Russo | Internal Medicine | 9850 Genesee Ave, Suite 350, La Jolla, CA 92037-1224 | 2006-04-19 |
| Street Address |
75 KINGS HIGHWAY CUTOFF SUITE 1A |
| City | FAIRFIELD |
| State | CT |
| Zip Code | 06824-5340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629506092 | Amanda Mckenzie | Physician Assistant | 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 | 2017-05-30 |
| 1821546607 | Danielle Marie Centone | Physician Assistant | 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 | 2016-09-21 |
| 1881958213 | Mona Hayat Marrash | Specialist/Technologist | 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 | 2012-06-29 |
| 1952671950 | Michelle Elena Stack | Clinical Neuropsychologist | 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 | 2012-01-06 |
| 1124346481 | Andrew Raymond Baxter | Surgery | 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 | 2010-05-12 |
| 1417191503 | Karen Lynn Brown | Physician Assistant | 75 Kings Highway Cutoff, Fairfield, CT 06824 | 2009-04-21 |
| 1134368475 | Caitlin F. Patry | Physical Therapist | 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 | 2009-02-10 |
| 1720232952 | Christine Mccarthy | Psychologist | 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 | 2008-11-14 |
| 1477705382 | Thomas Barton Toothaker | Psychiatry & Neurology | 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 | 2008-10-22 |
| 1699940551 | Nicholas Alfred Blondin | Psychiatry & Neurology | 75 Kings Highway Cutoff, Fairfield, CT 06824-5340 | 2008-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819826 | Lauren J Cotton | Student in an Organized Health Care Education/Training Program | 1073 North Benson Road, Fairfield, CT 06824 | 2020-07-28 |
| 1831652064 | Seagull Counseling & Therapy LLC | Social Worker | 35 Nutmeg Lane, Fairfield, CT 06824 | 2019-04-14 |
| 1871018390 | Richard Matthew Carraway | Nurse Practitioner | 117 Carlynn Drive, Fairfield, CT 06824 | 2017-08-05 |
| 1811426695 | Fairfield County Health & Wellness Services II LLC | Psychiatry & Neurology | 325 Reef Road/suite 109, Fairfield, CT 06824 | 2017-06-06 |
| 1487198214 | Evamarie Koehler Elinskas | Speech-Language Pathologist | 50 Potters Lane, Fairfield, CT 06824 | 2016-12-13 |
| 1447794441 | Nicholas C Kopazna | Counselor | 433 Meadow St, Fairfield, CT 06824 | 2016-12-09 |
| 1245686997 | Tyler Wayne Vitzthum | Chiropractor | 1995 Post Rd., Fairfield, CT 06824 | 2016-05-12 |
| 1184087660 | Beth Segaloff | Social Worker | 191 Catherine Terrace, Fairfield, CT 06824 | 2016-04-01 |
| 1518342781 | April Vanbergen | Counselor | 1275 Post Rd., Suite A5, Fairfield, CT 06824 | 2015-07-29 |
| 1982089181 | Mary Cilio | Social Worker | 173 Samp Mortar Drive, Fairfield, CT 06824 | 2015-07-29 |
| Find all providers in zip 06824 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437700531 | Fairfield Interventional and Vascular Specialists PC | Radiology | 1 Sasco Hill Rd Ste 2, Fairfield, CT 06824-5670 | 2019-09-20 |
| 1689090391 | Solano Diagnostics Imaging Medical Group | Radiology | 4500 Business Center Drive, Fairfield, CA 94534 | 2014-03-06 |
| 1255394227 | Bryson Dale Borg | Radiology | 4357 The Masters Dr, Fairfield, CA 94533-9514 | 2006-04-10 |
| 1336146802 | Gioia Jo Riccio | Radiology | 425 Post Rd, Fairfield, CT 06824-6232 | 2005-06-30 |
| 1114923893 | Orthopaedic Specialty Group, P.C. | Radiology | 305 Black Rock Tpke, Fairfield, CT 06825 | 2005-06-27 |
| 1972006534 | Solano Diagnostics Partners, A Calif Limited Partnership | Radiology | 4500 Business Center Dr, Fairfield, CA 94534-6888 | 2018-03-09 |
| 1548769284 | Bay Imaging Consultants Medical Group Inc | Radiology | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2018-02-08 |
| 1649778614 | Rdr Radiology LLC | Radiology | 425 Post Rd, Fairfield, CT 06824-6232 | 2018-01-25 |
| 1427414903 | Solano Diagnostics Partners, A Calif Limited Partnership | Radiology | 4500 Business Center Dr, Fairfield, CA 94534-6888 | 2016-01-13 |
| 1609264498 | Bay Imaging Consultants Medical Group | Radiology | 2700 Low Ct, Fairfield, CA 94534-9715 | 2014-12-31 |
| Find all providers in FAIRFIELD | ||||
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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.