Individual
MRS. SAMANTHA RUSSOMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
51 S PARK ST APT 302, MONTCLAIR, NJ 07042-2753
(862) 703-9379
Mailing address
51 S PARK ST APT 302, MONTCLAIR, NJ 07042-2753
(862) 703-9379
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86378698
NJ
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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