IndividualActive
Alyse Russo, MPAS, PA-C
NPI 1346516408 · Physician Assistant · Teaneck, NJ
Provider details
- NPI number
- 1346516408
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- MPAS, PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 25MP00279700 (NJ)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
870 Palisade Ave
Suite 302
Teaneck, NJ 07666-3419
Phone: (201) 836-9696
Approximate (ZIP-level) locationGet directions
Mailing address
16 Rainbow Trl
Denville, NJ 07834-3208
Registry dates
- Enumerated
- 2012-03-22
- Last updated
- 2015-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.