Provider Demographics
NPI:1215644224
Name:GIRESI, RUSSELL (BA PSY)
Entity type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:
Last Name:GIRESI
Suffix:
Gender:M
Credentials:BA PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9442 BARNSTEAD LN
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-4303
Mailing Address - Country:US
Mailing Address - Phone:727-226-5220
Mailing Address - Fax:
Practice Address - Street 1:9442 BARNSTEAD LN
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-4303
Practice Address - Country:US
Practice Address - Phone:727-226-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist