Individual
DR. MARC WILLIAM RUSSO
Active
Individual
DR. MARC WILLIAM RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
255454
NY
207L00000X
Anesthesiology Physician
Primary
25MA08706700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0243451
—
NJ
05
—
03534714
—
NY
01
—
3885700619
MYUTMB 3885700619-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
10/02/2024
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