Organization
NORTH JERSEY ORTHOPAEDIC & SPORTS MEDICINE INSTITUTE
Active
Organization
NORTH JERSEY ORTHOPAEDIC & SPORTS MEDICINE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL C RUSSONELLA DO (OWNER)
(973) 340-1940
Entity
Organization
Contact information
Practice address
6 BRIGHTON RD STE 101, CLIFTON, NJ 07012-1647
(973) 340-1940
(973) 340-1958
Mailing address
6 BRIGHTON RD STE 101, CLIFTON, NJ 07012-1647
(973) 340-1940
(973) 340-1958
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
25MB08615500
NJ
Other
Enumeration date
09/25/2009
Last updated
01/14/2016
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