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Organization
SOUTH MOUNTAIN MEDICAL ASSOCIATES,P.C.
Active
Organization
SOUTH MOUNTAIN MEDICAL ASSOCIATES,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTHONY RUSSO MD (PHYSICIAN)
(973) 736-8119
Entity
Organization
Contact information
Practice address
1500 PLEASANT VALLEY WAY, SUITE 302, WEST ORANGE, NJ 07052-2956
(973) 736-8119
Mailing address
1500 PLEASANT VALLEY WAY, SUITE 302, WEST ORANGE, NJ 07052-2956
(973) 736-8119
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA44815
NJ
Other
Enumeration date
10/29/2007
Last updated
07/20/2012
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