DIANE RUSSO (NPI# 1205474640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205474640 |
| Entity Type | Individual |
| Full Name | DIANE RUSSO |
| Credential | CASAC |
| Practice Address |
281 Phelps Ln North Babylon NY 11703-4005 |
| Mailing Address |
894 Walnut Ave Bohemia NY 11716-4228 |
| Practice Telephone | 6314227676 |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | OASAS CASAC | 0009943 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386987998 | Diane J. Russo | Physical Therapist | 18 Stuart Drive, Coram, NY 11727 | 2013-04-02 |
| 1568022333 | Diane Marie Russo | Counselor | 2090 Adam Clayton Powell Jr Blvd, New York, NY 10027-4990 | 2019-06-14 |
| 1174839146 | Diane Russo | Optometrist | 10 Lincoln Sq, Eye Care and Vision Center, Worcester, MA 01608-1135 | 2010-08-27 |
| 1467699868 | Diane Marie Russo | Occupational Therapist | 36 Violet Ave, Mineola, NY 11501-4624 | 2009-01-07 |
| 1871640490 | Diane Kay Russo | Chiropractor | 1475 Terrell Mill Rd Se, Suite 108, Marietta, GA 30067-6049 | 2007-01-04 |
| 1780623561 | Diane Russo | Dietitian, Registered | 4201 Tudor Centre Dr, Suite 320, Anchorage, AK 99508-5904 | 2006-06-06 |
| Street Address |
281 PHELPS LN |
| City | NORTH BABYLON |
| State | NY |
| Zip Code | 11703-4005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851702393 | Alexandra Lemma | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2014-05-19 |
| 1043845654 | Jared J Dowd | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4045 | 2020-03-04 |
| 1952951816 | Kimberly Ann Schumann | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2019-09-12 |
| 1316420714 | Christopher Gerald Callahan | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2018-09-11 |
| 1932625290 | Nicole Ashley Sullivan | Social Worker | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2017-08-18 |
| 1962939256 | Clarice Murphy-schmitt | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2017-05-17 |
| 1205386273 | Amy Castiglia | Registered Nurse | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2016-10-13 |
| 1134516180 | Denise Collin | Technician | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2015-04-16 |
| 1538553235 | Stephanie Sloan | Counselor | 281 Phelps Ln, Drug and Alcohol Services, North Babylon, NY 11703-4005 | 2015-03-20 |
| 1922404565 | Amanda Ammirati | Social Worker | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2014-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215405980 | Esther Williams Ekanem | Counselor | 391 Nelligan Ct, North Babylon, NY 11703 | 2018-11-10 |
| 1063968782 | Kimberly Myers | Speech-Language Pathologist | 523 Polaris Street, North Babylon, NY 11703 | 2016-09-01 |
| 1760830749 | Christian Nursing Registry | Nursing Care | 11 Faulkner Ave, North Babylon, NY 11703 | 2016-05-31 |
| 1932475308 | Michael Henry Polcino | Surgery | 796 Deep Park Avenue, North Babylon, NY 11703 | 2012-03-29 |
| 1801175468 | Jean Emelda Swan | Registered Nurse | 619 Mount Avenue, North Babylon, NY 11703 | 2011-08-12 |
| 1124354303 | Kim Shek | Registered Nurse | 134 Colonial Road, North Babylon, NY 11703 | 2009-10-23 |
| 1861633398 | Christine Ann Hedley | Registered Nurse | 91 East Shore Drive, Babylon, NY 11703 | 2009-03-12 |
| 1720232788 | Muriel Ellen Mccleave | Registered Nurse | 746 Deer Park Ave., No. Babylon, NY 11703 | 2008-11-04 |
| 1467625624 | Kathleen Uzzi Jeremiah | Nurse Practitioner | 1486 Deer Park, Unit A, North Babylon, NY 11703 | 2008-04-09 |
| 1992864938 | Jason B Hitner | Pediatrics | 925 Deer Park Ave, North Babylon, NY 11703 | 2006-12-06 |
| Find all providers in zip 11703 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437791886 | Joseph Olmedo | Counselor | 281 Phelps Lane - Annex Building, Drug & Alcohol Services, North Babylon, NY 11703-4005 | 2019-10-16 |
| 1215405980 | Esther Williams Ekanem | Counselor | 391 Nelligan Ct, North Babylon, NY 11703 | 2018-11-10 |
| 1255844460 | Kenrick Alfred | Counselor | 608 Johnson Avenue, Suite 2, North Babylon, NY 11703-1208 | 2017-11-09 |
| 1851702393 | Alexandra Lemma | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2014-05-19 |
| 1043845654 | Jared J Dowd | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4045 | 2020-03-04 |
| 1952951816 | Kimberly Ann Schumann | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2019-09-12 |
| 1316420714 | Christopher Gerald Callahan | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2018-09-11 |
| 1962939256 | Clarice Murphy-schmitt | Counselor | 281 Phelps Ln, North Babylon, NY 11703-4005 | 2017-05-17 |
| 1508308081 | Alvaro D Gonzalez-davila | Counselor | 281 Phelps Lane, Division of Drug & Alcohol Services, North Babylon, NY 11703-4005 | 2016-11-15 |
| 1538553235 | Stephanie Sloan | Counselor | 281 Phelps Ln, Drug and Alcohol Services, North Babylon, NY 11703-4005 | 2015-03-20 |
| Find all providers in NORTH BABYLON | ||||
| City | NORTH BABYLON |
| Zip Code | 11703 |
Please comment or provide details below to improve the information on DIANE 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.