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General NPI Number Information
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NPI Number | 1710835467
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Entity Type | Individual
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Provider Name | LAUREN NICOLE RUSSO OTR
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Gender | Female
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Dates
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Enumeration Date | 03/18/2026
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 38A GROVE ST STE 301
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City | RIDGEFIELD
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State | CT
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Zip | 06877-4664
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Country | US
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Telephone | 203-881-6339
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Fax |
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Provider Business Mailing Address
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Address Line | 211 DINGLE RIDGE RD
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City | BREWSTER
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State | NY
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Zip | 10509-5512
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Country | US
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Telephone | 914-582-6269
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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