Individual
DR. RICHARD WILLIAM RUSSILLO
Active
Individual
DR. RICHARD WILLIAM RUSSILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD-47149
IA
207LA0401X
Addiction Medicine (Anesthesiology) Physician
R-10612
IA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
R-10612
IA
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
R-10612
IA
207LP2900X
Pain Medicine (Anesthesiology) Physician
R-10612
IA
207LP3000X
Pediatric Anesthesiology Physician
R-10612
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD-47149
MEDICAL LICENSE
IA
Enumeration date
06/17/2016
Last updated
04/18/2025
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