Individual
ANTHONY RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 MADISON AVE, MADISON, NJ 07940-1868
(973) 822-2772
(973) 822-2773
Mailing address
549 WITTICH TER, RIVER VALE, NJ 07675-6005
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
25MA11647500
NJ
390200000X
Student in an Organized Health Care Education/Training Program
00000000000000000000
—
Other
Enumeration date
03/22/2019
Last updated
08/28/2023
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