IndividualActive
Mariela Perez Russo, MD, CNS
NPI 1811474612 · Nutritionist · Trumbull, CT
Provider details
- NPI number
- 1811474612
- Entity type
- Individual
- Primary specialty
- NutritionistDietary & Nutritional Service Providers
- Credential
- MD, CNS
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1644 (CT)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Dietary & Nutritional Service Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
290 Booth Hill Rd
Trumbull, CT 06611-4943
Phone: (646) 255-9510
Street-level locationGet directions
Mailing address
290 Booth Hill Rd
Trumbull, CT 06611-4943
Registry dates
- Enumerated
- 2018-07-24
- Last updated
- 2018-07-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.