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NPI Code Detail

MEDICARE: MRS. DARLENE RUSSO MS, CCC-SLP, TSSLD

MEDICARE:  MRS. DARLENE  RUSSO  MS, CCC-SLP, TSSLD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1144505769
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DARLENE RUSSO MS, CCC-SLP, TSSLD
Provider Business Mailing Address
First Line : 410 CLAREMONT AVE
Second Line :
City : WEST BABYLON
State : NY
Zip : 11704-4020
Country : US
Telephone Number : 631-914-4983
Fax Number :
Provider Business Practice Location Address
First Line : 410 CLAREMONT AVE
Second Line :
City : WEST BABYLON
State : NY
Zip : 11704-4020
Country : US
Telephone Number : 631-914-4983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2011
Last Update Date : 03/04/2026

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Directions to “ MRS. DARLENE RUSSO MS, CCC-SLP, TSSLD” Practice Location

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