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Individual

DR. JOHN ANTHONY RUSSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 PLEASANT VALLEY WAY STE 201, WEST ORANGE, NJ 07052-2956
(973) 736-8119
(973) 736-6818
Mailing address
1500 PLEASANT VALLEY WAY STE 201, WEST ORANGE, NJ 07052-2956
(973) 736-8119
(973) 736-6818

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA44815
NJ

Other

Enumeration date
02/25/2007
Last updated
11/01/2007
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