Russo, Neil J

Russo, Neil J is an individual health care provider with primary practice located at 375 Mount Pleasant Ave Suite 202, West Orange NJ 07052-2724. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Russo, Neil J can be contacted via phone (973) 731-7707.

Contact Information

Primary practice address
375 Mount Pleasant Ave Suite 202 West Orange NJ 07052-2724
Phone: (973) 731-7707
Fax: (973) 669-0277
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MA 56453 New Jersey

Profile Details

NPI number 1235290966
LBN Legal business name Russo, Neil J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jul 11th, 2019 - about 5 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 1235290966 NPPES
Other 1 K3466 PHS
Other EP241 PHS
Other 5383958 PHS
MEDICAID 766860NYH PHS
Other 2243108 PHS

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