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1720738263
CHRISTINE ELIZABETH RUSSO
STONY BROOK, NY
NPI
1720738263
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Former Name
CHRISTINE NASTASI
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: NY 383362)
Enumeration Date
2022-03-27
Last Update Date
2022-03-27
Business Address
CHRISTINE ELIZABETH RUSSO CPNP-PC
101 NICOLLS RD
STONY BROOK, NY 11794-0001
Phone number: 631-682-3289
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Mailing Address
CHRISTINE ELIZABETH RUSSO CPNP-PC
136 WINDWARD DR
PORT JEFFERSON, NY 11777-2331
Phone number: 631-682-3289
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