Mariela Perez Russo, MD, CNS
Nutritionist in Trumbull, Connecticut
1811474612- Practice location
- 290 Booth Hill RD, Trumbull, CT 06611-4943
- Phone
- 646-255-9510
- Fax
- —
- Last updated
- July 24, 2018
Mariela Perez Russo is a Nutritionist based in Trumbull, CT. Mariela Perez Russo practices in Trumbull, CT and has the professional credentials of MD, CNS. The NPI Number for Mariela Perez Russo is 1811474612 and holds a License No. 1644 (CT). The current practice location address for Mariela Perez Russo is 290 Booth Hill RD, Trumbull, CT 06611-4943 and can be reached out via phone at 646-255-9510.
Provider Profile Details
- NPI Number
- 1811474612
- Provider Name
- Mariela Perez Russo
- Credential
- MD, CNS
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 290 Booth Hill RD, Trumbull, CT 06611-4943
- Phone Number
- 646-255-9510
- Primary Taxonomy
- Nutritionist · 133N00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- July 24, 2018
- Last Update Date
- July 24, 2018
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 290 Booth Hill RD
Trumbull, CT 06611-4943 - City
- Trumbull
- State
- Connecticut
- Zip
- 06611-4943
- Phone Number
- 646-255-9510
Provider Business Mailing Address Details
- Address
- 290 Booth Hill RD
Trumbull, CT 06611-4943 - City
- Trumbull
- State
- CT
- Zip
- 06611-4943
- Phone Number
- 646-255-9510
License Information
- License Number (1)
- 1644
- License State (1)
- CT
- Taxonomy (1)
- Nutritionist · 133N00000X
- Taxonomy (2)
- Nutritionist · 133N00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Nutritionists near Trumbull, CT
View all Nutritionists in Trumbull →Frequently Asked Questions
What is the NPI number of Mariela Perez Russo, MD, CNS?
The NPI number of Mariela Perez Russo, MD, CNS is 1811474612. It was assigned on July 24, 2018 and is currently active in the NPPES registry.
What is the specialty of Mariela Perez Russo, MD, CNS?
Mariela Perez Russo, MD, CNS is registered under the primary taxonomy Nutritionist (code 133N00000X), licensed in CT under license number 1644.
Where does Mariela Perez Russo, MD, CNS practice?
The practice location is 290 Booth Hill RD, Trumbull, CT 06611-4943. The office can be reached at 646-255-9510 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1811474612 directly on the NPPES registry website.