| Nicholas Russo, | |
|
16811 N Litchfield Rd Ste 101, Surprise, AZ 85374-7062 | |
| (602) 313-4045 | |
| (623) 322-0664 |
| Full Name | Nicholas Russo |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 16811 N Litchfield Rd Ste 101, Surprise, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053915819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (Arizona) | Primary |
| 225100000X | Physical Therapist | PT36549 (Florida) | Secondary |
| Provider Name | Ati Holdings Of Arizona Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1871570309 PECOS PAC ID: 2466732862 Enrollment ID: O20161130001683 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas Russo, 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: () - | Nicholas Russo, 16811 N Litchfield Rd Ste 101, Surprise, AZ 85374-7062 Ph: (602) 313-4045 |
Ashley Rubenstein, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 14239 W Bell Rd Ste 104, Surprise, AZ 85374 Phone: 623-600-8333 | |
Dr. Kathleen Nicole Shafer, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 15543 N Reems Rd, Surprise, AZ 85374 Phone: 623-975-5374 | |
Northwest Orthopedic & Sports Physical Therapy Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 14800 W Mountain View Blvd Ste 260, Surprise, AZ 85374 Phone: 623-556-5013 Fax: 623-556-9290 | |
Elana Trejo, Physical Therapist Medicare: Medicare Enrolled Practice Location: 13933 W Grand Ave, Surprise, AZ 85374 Phone: 623-474-3952 | |
Arizona Mobile Therapy Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 15239 W Alexandria Way, Surprise, AZ 85379 Phone: 480-698-6049 Fax: 480-371-2743 | |
Ms. Patricia Ann Graham, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 15802 North Parkview Place, Surprise, AZ 85374 Phone: 623-876-7022 Fax: 623-876-7060 |