Individual
DR. MICHAEL C RUSSONELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6 BRIGHTON ROAD STE 101, NORTH JERSEY ORTHOPAEDIC & SPORTS MEDICINE INSTITUTE LL, CLIFTON, NJ 07012-1647
(973) 340-1940
(973) 340-1958
Mailing address
6 BRIGHTON ROAD STE 101, NORTH JERSEY ORTHOPAEDIC & SPORTS MEDICINE INSTITUTE LL, CLIFTON, NJ 07012-1647
(973) 340-1940
(973) 340-1958
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25MB08615500
NJ
207XP3100X
Pediatric Orthopaedic Surgery Physician
239683-1
NY
Other
Enumeration date
05/28/2007
Last updated
02/02/2016
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