Individual
SALVATORE J RUSSOMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3100 HINGSTON AVE STE 104, EGG HARBOR TOWNSHIP, NJ 08234-4409
(888) 985-2727
Mailing address
PO BOX 8627, CHERRY HILL, NJ 08002-0627
(856) 755-1616
(856) 755-0098
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MA0509100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0313495000
AMERIHEALTH HMO
NJ
01
—
1119428
HORIZON NJ HEALTH
NJ
01
—
11535
AIG MVA/WORKMANS COMP
—
01
—
1258829
UNITED HEALTHCARE
NJ
01
—
223233709
TAX ID
NJ
01
—
250004594
RAILROAD MEDICARE
NJ
01
—
4306370
AETNA HMO/PPO
—
01
—
487258
AMERIHEALTH PPO
NJ
05
—
5503400
—
NJ
01
—
ATS024
OXFORD
NJ
Enumeration date
05/10/2006
Last updated
11/28/2022
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