KELLY A RUSSO (NPI# 1326115841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326115841 |
| Entity Type | Individual |
| Full Name | KELLY A RUSSO |
| Credential | PT, DPT, NCS, ATP |
| Practice Address |
414 Paoli Pike Malvern PA 19355-3311 |
| Mailing Address |
82 Tucker Dr Downingtown PA 19335-1457 |
| Practice Telephone | 4845967894 |
| Mailing Telephone | 4437396993 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2019-01-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251N0400X |
Physical Therapist Specialization: Neurology |
PA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467466656 | Kelly Sipe Russo | Internal Medicine | 1 Harry S Truman Pkwy, Ms 3102, Annapolis, MD 21401-7037 | 2006-07-27 |
| 1487218012 | Kelly Russo | Speech-Language Pathologist | 9047 W Greenfield Ave, West Allis, WI 53214-2800 | 2019-04-29 |
| 1073822409 | Kelly Lynn Russo | Speech-Language Pathologist | 51 St Johns Parkside, Buffalo, NY 14210-2515 | 2010-10-04 |
| 1326362815 | Kelly T Russo | Pharmacist | 11 E Main St, Marcellus, NY 13108-1224 | 2010-03-26 |
| 1770805830 | Kelly White Russo | Pharmacist | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2010-02-17 |
| 1265664734 | Kelly L Russo | Psychologist | 1767 Village Park Dr, Orangeburg, SC 29118-2475 | 2009-08-18 |
| Street Address |
414 PAOLI PIKE |
| City | MALVERN |
| State | PA |
| Zip Code | 19355-3311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386616449 | Lance S Roberts | Physical Medicine & Rehabilitation | 414 Paoli Pike, Malvern, PA 19355-3311 | 2006-02-03 |
| 1548878580 | Jaclyn Grenier | Physical Therapist | 414 Paoli Pike, Malvern, PA 19355-3311 | 2020-07-15 |
| 1174149025 | Brian Scott Kriebel | Physical Therapist | 414 Paoli Pike, Malvern, PA 19355-3300 | 2020-06-17 |
| 1316567076 | Benjamin Schreiber | Physical Therapist | 414 Paoli Pike, Malvern, PA 19355-3311 | 2020-04-23 |
| 1255999207 | Victoria Kramp | Occupational Therapist | 414 Paoli Pike, Malvern, PA 19355-3311 | 2019-06-04 |
| 1396308466 | Meghan Kincaid | Speech-Language Pathologist | 414 Paoli Pike, Malvern, PA 19355-3311 | 2019-04-15 |
| 1275985327 | Maureen Perno | Clinical Neuropsychologist | 414 Paoli Pike, Malvern, PA 19355 | 2016-07-12 |
| 1225486319 | Katherine Streitel Borst | Internal Medicine | 414 Paoli Pike, Malvern, PA 19355-3311 | 2016-05-30 |
| 1477900587 | Rehabilitation Associates of The Main Line PC | Non-Pharmacy Dispensing Site | 414 Paoli Pike, Malvern, PA 19355-3311 | 2016-05-18 |
| 1477923506 | Douglas Kawka | Psychologist | 414 Paoli Pike, Malvern, PA 19355-3311 | 2015-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588218044 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 30 Liberty Boulevard, Suite 140, Malvern, PA 19355 | 2019-08-01 |
| 1871011122 | Mary Margaret Bischoff | Psychologist | 922 St. Andrews Dr., Malvern, PA 19355 | 2017-09-07 |
| 1114449527 | Reconstructive Orthopaedic Associates II, P.C. | Prosthetic/Orthotic Supplier | 650 Carnegie Boulevard, 2nd Floor, Malvern, PA 19355 | 2017-07-07 |
| 1285169243 | Smile Exchange of Malvern, LLC | Clinic/Center | 5 S. Morehall Rd, Suite 700b, Malvern, PA 19355 | 2017-04-27 |
| 1669849162 | Sahar Akhtar | Counselor | 288 Lancaster Ave Ste 1, Frazer, PA 19355 | 2015-08-31 |
| 1386020030 | Laura Ann Treston | Physical Therapy Assistant | 60 Malvern Ave., Malvern, PA 19355 | 2015-08-05 |
| 1003217191 | Hillary Schmid | Behavioral Analyst | 28 Clover Lane, Malvern, PA 19355 | 2014-09-09 |
| 1033528799 | James Greco | Pharmacist | 50 Three Tun Rd Ste 2, Malvern, PA 19355 | 2014-08-07 |
| 1952712085 | Rachael Joseph | Community/Behavioral Health | 45 Kelmar Avenue, Malvern, PA 19355 | 2014-05-12 |
| 1487081808 | Ronia Arabatlian | Social Worker | 1 North Bacton Rd, 107, Malvern, PA 19355 | 2013-09-30 |
| Find all providers in zip 19355 | ||||
| Taxonomy Code | 2251N0400X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Neurology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878580 | Jaclyn Grenier | Physical Therapist | 414 Paoli Pike, Malvern, PA 19355-3311 | 2020-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891254793 | Valerie Leigh Marchion | Physical Therapist | 642 Newtown Yardley Rd Ste 120, Newtown, PA 18940-1775 | 2019-03-19 |
| 1598298929 | Carol Ann Davidson | Physical Therapist | 7103 Sherman St, Philadelphia, PA 19119-3306 | 2017-04-04 |
| 1912235656 | Kristine Sue Legters | Physical Therapist | 129 W 36th St, Erie, PA 16508-2903 | 2009-11-18 |
| 1003095324 | Personal Touch Rehab and Fitness | Physical Therapist | 8118 Old York Road, Ul, Elkins Park, PA 19027-1900 | 2007-11-02 |
| 1649210402 | Georgette Irene Driskill | Physical Therapist | 412 Creamery Way, Suite 300, Exton, PA 19341-2551 | 2006-06-08 |
| 1104871987 | Kiersten Shevchik | Physical Therapist | 6729 Fieldcrest Dr, Delmont, PA 15626-7209 | 2006-05-23 |
| 1477163368 | Ryan Ellis | Physical Therapist | 69 Cottage Rd, Mifflin, PA 17058-7030 | 2020-08-05 |
| 1962022590 | Rachel Mcclelland | Physical Therapist | 1513 Race St, Philadelphia, PA 19102-1125 | 2020-04-23 |
| 1164058301 | Kyle Anthony Cunningham | Physical Therapist | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-03-19 |
| 1427682269 | Vanessa Marciello | Physical Therapist | 1534 Park Ave Ste 110, Quakertown, PA 18951-1085 | 2020-03-02 |
| Find all providers with the same taxonomy | ||||
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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.