Organization
GENESIS METABOLICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN ANN RUSSOMANO RN BSN (REGISTERED AGENT/MEMBER/MANAGER)
(908) 851-0455
Entity
Organization
Contact information
Practice address
2801 MORRIS AVE, UNION, NJ 07083-4821
(908) 851-0455
(908) 851-0708
Mailing address
2801 MORRIS AVE, UNION, NJ 07083-4821
(908) 851-0455
(908) 851-0708
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/25/2018
Last updated
03/27/2025
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