Individual
MICHAEL RUSSONIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16 POCONO RD, STE 209, DENVILLE, NJ 07834-2901
(973) 625-5651
Mailing address
16 POCONO RD, STE 209, DENVILLE, NJ 07834-2901
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MA37902
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1612506
—
NJ
Enumeration date
05/12/2006
Last updated
05/11/2023
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