Organization
NJIB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S. RUSSO DPT (OWNER)
(908) 353-0500
Entity
Organization
Contact information
Practice address
864 BROADWAY, BAYONNE, NJ 07002-3054
(201) 339-1109
(908) 353-1505
Mailing address
864 BROADWAY, BAYONNE, NJ 07002-3054
(201) 339-1109
(908) 353-1505
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
08/05/2020
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