Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Taylor Marie Russo I, MSPAS, PA-C

Individual provider Medical Physician Assistant · NPI 1265206916

Taylor Marie Russo I, MSPAS, PA-C is a Medical Physician Assistant in New York, New York. Licensed in New York. Registered with an NPI since 2023.

Licensed in
NY
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

65 Broadway Fl 21
New York, NY 10006-2510
Phone: (212) 818-0001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 031037-01 (NY)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 031037-01 (NY)

Record details

NPI number1265206916
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSPAS , PA-C
Sole proprietorNo
NPI enumeratedNovember 13, 2023
Last updated in NPPESNovember 13, 2023
Certification dateNovember 13, 2023

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