Organization
GREGORY DERUSSO LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY DERUSSO MD (PRESIDENT)
(215) 333-7505
Entity
Organization
Contact information
Practice address
7505 BUSTLETON AVE, PHILADELPHIA, PA 19152-4136
(215) 333-7505
(215) 333-8131
Mailing address
7505 BUSTLETON AVE, PHILADELPHIA, PA 19152-4136
(215) 333-7505
(215) 333-8131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/12/2007
Last updated
08/22/2020
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