Organization
VALLEY OB & GYN ASSOC P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RUSSO MD (DELEGATED OFFICIAL)
(201) 843-2800
Entity
Organization
Contact information
Practice address
80 EISENHOWER DR, SUITE 200, PARAMUS, NJ 07652-1401
(201) 843-2800
Mailing address
80 EISENHOWER DR, SUITE 200, PARAMUS, NJ 07652-1401
(201) 843-2800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA06406200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0414170000
AMERIHEALTH GROUP #
NJ
01
—
114590
AETNA HMO GROUP #
NJ
01
—
2015571
AETNA PPO GROUP #
NJ
01
—
CA8521
RAILROAD MEDICARE GROUP #
NJ
Enumeration date
06/17/2006
Last updated
11/15/2012
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