Individual
GABRIELLE RUSSILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
222 COLUMBIA TPKE STE 280, FLORHAM PARK, NJ 07932-1299
(973) 541-8138
(973) 800-1949
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00713400
NJ
Other
Enumeration date
07/08/2022
Last updated
05/30/2024
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