Individual
DR. JOSEPH L RUSSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 E NORWEGIAN ST, POTTSVILLE, PA 17901
(570) 621-4000
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD027472-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052844000
INDEPENDENCE BLUE CROSS
PA
01
—
4088946
AETNA
PA
01
—
RU98885
HIGHMARK BLUE SHIELD
PA
Enumeration date
06/08/2006
Last updated
08/09/2018
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