Individual
JOHN J RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
10 SCHALKS CROSSING RD, PLAINSBORO, NJ 08536-1612
(609) 275-8989
(609) 275-9327
Mailing address
7 PANNICK DR, HAMILTON, NJ 08610-1129
(609) 585-6967
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OAO 4698
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0641930001
MEDICARE NSC
NJ
Enumeration date
04/25/2006
Last updated
08/08/2008
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