Organization
MICHAEL C RUSSONELLA ORTHOPEDIC SURGEON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RUSSONELLA DO (OWNER)
(973) 340-1940
Entity
Organization
Contact information
Practice address
14 N MAIN ST STE 1, SPRING VALLEY, NY 10977-4942
(973) 340-1940
Mailing address
14 N MAIN ST STE 1, SPRING VALLEY, NY 10977-4942
(973) 340-1940
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
01/05/2022
Last updated
01/05/2022
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