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Mrs. Lisa Maria Russo, RD
Pediatric Nutrition Registered Dietitian in Elizabeth, New Jersey
NPI 1831245687

Lisa Maria Russo is a Pediatric Nutrition Registered Dietitian based in Hoboken, NJ and is specialized in Nutrition, Pediatric. Lisa Maria Russo practices in Elizabeth, NJ and has the professional credentials of RD. The NPI Number for Lisa Maria Russo is 1831245687 and holds a License No. 952153 (New Jersey).

The current practice location address for Lisa Maria Russo is 216 Palmer St, Elizabeth, NJ and can be reached out via phone at 908-353-0500. You can also correspond with Lisa Maria Russo through the mailing address at 10 CHURCH TOWERS, HOBOKEN, NJ - 07030 (mailing address contact number: 973-460-0616).

Location: 216 Palmer St, Elizabeth, NJ, 07030
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1831245687
Provider Name
Lisa Maria Russo
Credential
RD
Provider Entity Type
Individual
Gender
Female
Address
216 Palmer St, Elizabeth, NJ, 07030
Phone Number
908-353-0500
Fax Number
Provider Enumeration Date
01/26/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0251854103 01 NJ UNITED HEALTH CARE
11452348 01 NJ COUNCIL OF AFFORDABLE QUA
223452311 01 NJ HORIZON BLUE CROSS
3980567 01 NJ AETNA US HEALTHCARE
P3595969 01 NJ OXFORD
223452311 01 NJ GREAT WEST
institution
Provider Business Practice Location Address Details
Address
216 Palmer St
City
Elizabeth
State
New Jersey
Zip
07202-5900
Phone Number
908-353-0500
Fax Number
person
Provider Business Mailing Address Details
Address
10 Church Towers
City
Hoboken
State
New Jersey
Zip
07030
Phone Number
973-460-0616
Fax Number
person
Provider's Taxonomy Details 1
Type
Dietary & Nutritional Service Providers
Classification
Dietitian, Registered
Speciality
Nutrition, Pediatric
Taxonomy
133VN1004X
License No.
952153 (New Jersey)
Definition
An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition.
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