Individual
DR. DANIEL ALEXANDER RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
562 W 2ND AVE, LITITZ, PA 17543-1816
(717) 626-2167
Mailing address
562 W 2ND AVE, LITITZ, PA 17543-1816
(717) 626-2167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD468073
PA
207Q00000X
Family Medicine Physician
MT213545
PA
Other
Enumeration date
05/30/2017
Last updated
06/14/2020
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