Individual
DR. STEPHEN M DIRUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4422 3RD AVE, ST. BARNABAS HOSPITAL DEPT SURGERY 2ND FLOR MILLS BLVD, BRONX, NY 10457-2545
(718) 960-6127
Mailing address
4422 THIRD AVE, DEPT OF SURGERY 2ND FLOOR MILLS BUILDING, BRONX, NY 10457
(718) 960-6127
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
203772
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1724423
—
NY
Enumeration date
01/03/2007
Last updated
12/04/2008
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