Russo, Melchiorre Joseph

Russo, Melchiorre Joseph is an individual health care provider with primary practice located at 128 Valley Rd , Clifton NJ 07013-1121. He recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as his primary health care specialty. Russo, Melchiorre Joseph can be contacted via phone (973) 279-5116.

Contact Information

Primary practice address
128 Valley Rd Clifton NJ 07013-1121
Phone: (973) 279-5116
Fax: (973) 279-8899
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X MA48796 New Jersey

Profile Details

NPI number 1245291277
LBN Legal business name Russo, Melchiorre Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Jul 9th, 2008 - 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 1245291277 NPPES
New Jersey MEDICAID 2103907

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