Individual
PIERANTONIO RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
790 TOWNSHIP LINE RD STE 300, YARDLEY, PA 19067-4262
(215) 738-0211
(571) 778-5077
Mailing address
3 SAINT MORITZ LN, CHERRY HILL, NJ 08003-5123
(215) 738-0211
(571) 778-5077
Taxonomy
Speciality
Code
Description
License number
State
2083C0008X
Clinical Informatics Physician
Primary
MD040326E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205679004
—
MO
01
—
P00106634
RR MEDICARE
MO
Enumeration date
05/24/2006
Last updated
12/04/2022
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