Healthcare Provider Details

I. General information

NPI: 1851225718
Provider Name (Legal Business Name): CHRISTINA RUSSO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 GENESEE ST STE 1
ONEIDA NY
13421-2658
US

IV. Provider business mailing address

126 CHAPEL ST
SHERRILL NY
13461-1005
US

V. Phone/Fax

Practice location:
  • Phone: 315-363-8862
  • Fax:
Mailing address:
  • Phone: 401-837-5888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number359926
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: