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Organization

GARY E RUSSOLILLO MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY EDWARD RUSSOLILLO MD (PRESIDENT)
(860) 521-2200
Entity
Organization

Contact information

Practice address
970 FARMINGTON AVE, WEST HARTFORD, CT 06107-2139
(860) 521-2200
(860) 521-2605
Mailing address
970 FARMINGTON AVE, WEST HARTFORD, CT 06107-2139
(860) 521-2200
(860) 521-2605

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Enumeration date
03/23/2009
Last updated
03/23/2009
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