Individual
ANTHONY ROBERT RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 726-2000
Mailing address
51 PHILLIPS ST APT 10, BOSTON, MA 02114-3657
(631) 793-8174
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
1025979
MA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/23/2022
Last updated
06/10/2026
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