SELENA ROSE RUSSO

AIEA, HI
NPI1801300694
Former NameSELENA ROSE NIETO BALLESTERO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: HI  AMD-1004)
Enumeration Date2017-12-01
Last Update Date2024-10-29
Business Address
SELENA ROSE RUSSO PA-C
99-115 AIEA HEIGHTS DR STE 276B
AIEA, HI 96701-3924
Phone number: 808-784-3050
Mailing Address
SELENA ROSE RUSSO PA-C
99-115 AIEA HEIGHTS DR STE 276B
AIEA, HI 96701-3924
Phone number: 718-249-5360
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