Individual
DR. STANLEY JOSEPH RUSSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-4973
(570) 214-9585
(570) 214-9519
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD031740E
PA
208M00000X
Hospitalist Physician
Primary
MD031740E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011826880005
—
PA
05
—
02654502
—
NY
Enumeration date
02/14/2006
Last updated
07/31/2020
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