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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

DOMENICK RUSSO
NPI 1871424309
Nurse Practitioner - Acute Care in Stony Brook, NY

Active since May 26, 2026
101 NICOLLS RD, STONY BROOK, NY 11794(631) 774-3491 Get Directions Write a Review

NPPES record added: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Domenick Russo NPPES

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

DOMENICK RUSSO (NPI 1871424309) is an individual acute care provider in Stony Brook, New York, licensed in New York (433662) and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1871424309
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameDOMENICK RUSSO
Location Address101 NICOLLS RDStony Brook, NY 11794-0001
Mailing Address101 Nicolls RdStony Brook, NY 11794-0001
Phone(631) 774-3491
Sole ProprietorNo
Enumeration DateMay 26, 2026
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1871424309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in NY · 433662
101 NICOLLS RD, Stony Brook, NY 11794
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Other Providers at the Same Location NPPES 20

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

NARINDER SINGH M.D.
Internal Medicine
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 444-4000
DR. KANHAI FARRAKHAN MD
Internal Medicine (Gastroenterology)
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 444-0580
MS. HAYLEY ALEXANDRA MENA LMSW
Social Worker (Clinical)
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (516) 761-4107
MRS. HEATHER MARIE CALIGIURI ANP
Nurse Practitioner (Adult Health)
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 631-4449
MR. SAM TARIK MENDOUNE I NP
Nurse Practitioner (Adult Health)
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 335-1657
ALEXIE LESSING
Student in an Organized Health Care Education/Training Program
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 444-4686
DR. BENJAMIN RISMANY MD
Student in an Organized Health Care Education/Training Program
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 444-1791
JULIA RYAN MD
Student in an Organized Health Care Education/Training Program
101 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 689-8333

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 Domenick Russo's NPI number?

The NPI number for Domenick Russo is 1871424309. It was assigned to this individual provider in the NPPES registry on May 26, 2026.

Where is Domenick Russo located?

Domenick Russo practices at 101 Nicolls Rd, Stony Brook, NY 11794. The listed phone number is (631) 774-3491.

What is Domenick Russo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

When was this NPI record last updated?

The NPPES record for Domenick Russo was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 days 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.