Russo, Joseph A

Russo, Joseph A is an individual health care provider with primary practice located at 575 Boylston St Suite 2, Newton Centre MA 02459-2740. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Russo, Joseph A can be contacted via phone (617) 964-1440.

Contact Information

Primary practice address
575 Boylston St Suite 2 Newton Centre MA 02459-2740
Fax: (617) 964-7833
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 80064 Massachusetts

Profile Details

NPI number 1598732240
LBN Legal business name Russo, Joseph A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598732240 NPPES
Massachusetts Other J09148 BLUE CROSS BLUE SHIELD

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