Healthcare Provider Details

I. General information

NPI: 1235061896
Provider Name (Legal Business Name): MS. EMMA CLAIRE RUSSI I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 ALTA VISTA DR
IMPERIAL PA
15126-2178
US

IV. Provider business mailing address

143 ALTA VISTA DR
IMPERIAL PA
15126-2178
US

V. Phone/Fax

Practice location:
  • Phone: 814-874-5300
  • Fax: 814-874-5303
Mailing address:
  • Phone: 814-874-5300
  • Fax: 814-874-5303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: