Individual
DR. RALPH E RUSSO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
728 MARNE HWY STE 200A, MOORESTOWN, NJ 08057-3128
(856) 291-8855
(856) 291-5526
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
25MA05172300
NJ
207UN0901X
Nuclear Cardiology Physician
Primary
25MA05172300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004199975
AETNA
—
05
—
4562704
—
NJ
01
—
BNS045
OXFORD
—
01
—
F01230
HEALTHNET
—
Enumeration date
03/07/2006
Last updated
10/10/2024
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