# JOSEPH L RUSSINO MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144775511
- **Authorized official:** JOSEPH L RUSSINO M.D. (OWNER/PHYSICIAN)
- **Authorized official phone:** (484) 383-8118

## Contact information

- **Practice address:** 462 E KING RD, MALVERN, PA 19355-3267
- **Practice address phone:** (484) 383-8118
- **Practice address fax:** (484) 383-8119
- **Mailing address:** 462 E KING RD, MALVERN, PA 19355-3267
- **Mailing address phone:** (484) 383-8118
- **Mailing address fax:** (484) 383-8119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VX0000X | Obstetrics Physician | MD027472E | PA | Yes |

## Other

- **Enumeration date:** 08/16/2016
- **Last updated:** 08/16/2016