Individual
MR. NEIL J RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 MOUNT PLEASANT AVE, SUITE 202, WEST ORANGE, NJ 07052-2724
(973) 731-7707
(973) 669-0277
Mailing address
375 MOUNT PLEASANT AVE, SUITE 202, WEST ORANGE, NJ 07052-2724
(973) 731-7707
(973) 669-0277
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MA 56453
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1 K3466
PHS
—
01
—
2243108
AETNA
—
01
—
5383958
CIGNA
—
05
—
766860NYH
—
NJ
01
—
EP241
OXFORD
—
Enumeration date
12/13/2006
Last updated
07/11/2019
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