Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kallista Russo

Individual provider Physical Therapist · NPI 1548094964

Kallista Russo is a Physical Therapist in Manalapan, New Jersey. Licensed in New Jersey. Registered with an NPI since 2024.

Licensed in
NJ
In the registry since
2024

Practice location Address checks out

300 Gordons Corner Rd Ste 2
Manalapan, NJ 07726-3150
Phone: (732) 851-7642
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA02283600 (NJ)

Record details

NPI number1548094964
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 28, 2024
Last updated in NPPESAugust 28, 2024
Certification dateAugust 28, 2024
Mailing address38 Bayview Dr, Brick, NJ 08723-7461

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