Individual
PATRICIA RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
32 GIBRALTAR DR, MORRIS PLAINS, NJ 07950-1273
(862) 219-5678
(862) 219-5399
Mailing address
32 GIBRALTAR DR, MORRIS PLAINS, NJ 07950-1273
(862) 219-5678
(862) 219-5399
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00352100
NJ
Other
Enumeration date
12/24/2008
Last updated
12/24/2008
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