TAYLOR MARIE RUSSO I MSPAS, PA-C
NPI 1265206916
Physician Assistant - Medical in New York, NY

Active since November 13, 2023
65 BROADWAY FL 21, NEW YORK, NY 10006(212) 818-0001 Get Directions Write a Review

NPPES record last updated: November 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Taylor Marie Russo I Mspas, Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAYLOR MARIE RUSSO I MSPAS, PA-C (NPI 1265206916) is an individual medical provider in New York, New York, licensed in New York (031037-01) and active in the NPI registry since November 2023.

NPPES Registry Identity

NPI1265206916
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameTAYLOR MARIE RUSSO ICredential: MSPAS, PA-C
Location Address65 BROADWAY FL 21New York, NY 10006-2510
Mailing Address163 Cuba AveStaten Island, NY 10306-4909 · (347) 737-9488
Sole ProprietorNo
Enumeration DateNovember 13, 2023
NPPES CertifiedNovember 13, 2023
NPI 1265206916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in NY · 031037-01
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 031037-01 (NY)
65 BROADWAY FL 21, New York, NY 10006

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
65 BROADWAY FL 21
NEW YORK, NY 10006
Clinic/Center (Ambulatory Surgical)
65 BROADWAY FL 21
NEW YORK, NY 10006

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Taylor Russo's NPI number?

The NPI number for Taylor Russo is 1265206916. It was assigned to this individual provider in the NPPES registry on November 13, 2023.

Where is Taylor Russo located?

Taylor Russo practices at 65 Broadway Fl 21, New York, NY 10006. The listed phone number is (212) 818-0001.

What is Taylor Russo's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Taylor Russo was last updated on November 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.