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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DAVID P RUSSO, M.D., FACS

Active Sole Proprietor

DAVID P RUSSO, M.D., FACS is a Addiction Medicine (Internal Medicine) healthcare provider located in BRIDGETON, New Jersey. NPI 1588647143 is currently active in the NPPES registry. Verify at CMS.

Addiction Medicine (Internal Medicine) · BRIDGETON, NJ

Registration Details

NPI Number
1588647143
Provider Type
Individual
Gender
Male
NPI Issued
Nov 28, 2005 (20.679461538447 yrs)
Last Updated
Aug 14, 2020
Licenses
25MA05056300 (NJ)
25MA05056300 (NJ)
Sole Proprietor
Yes

Practice Information

Address
133 POLK LN
BRIDGETON, NJ, 083025905
Browse NJ providers · Browse ZIP 08302
Phone
8007617575
Primary Specialty
Addiction Medicine (Internal Medicine)
207RA0401X
Additional Specialty
General Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.