Organization
DAVID P RUSSO MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID P RUSSO M.D. (OWNER)
(570) 421-8921
Entity
Organization
Contact information
Practice address
175 E BROWN ST, E STROUDSBURG, PA 18301-3098
(570) 421-8921
(570) 424-7370
Mailing address
PO BOX 1498, KINGSTON, PA 18704-0498
(570) 208-5530
(570) 208-5548
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD043941L
PA
Other
Enumeration date
01/24/2011
Last updated
01/24/2011
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