Sandra L Russo, DO is a
Family Medicine physician based in Woodbine, New Jersey. Sandra L Russo is licensed to practice in New Jersey (license number 25MB06190900) and her current practice location is 713 Dehirsch Ave, Woodbine, New Jersey. She can be reached at her office (for appointments etc.) via phone at
(609) 861-4241.
NPI number for Sandra L Russo is 1467404251 and her current mailing address is 713 Dehirsch Ave, Woodbine, New Jersey. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1467404251.
Physician's Profile
| Full Name | Sandra L Russo |
|---|
| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 713 Dehirsch Ave, Woodbine, New Jersey |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1467404251
- Provider Enumeration Date: 05/17/2006
- Last Update Date: 09/15/2010
Medical Identifiers
Medical identifiers for Sandra L Russo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1467404251 | NPI | - | NPPES |
| 7011008 | Medicaid | NJ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 25MB06190900 (New Jersey) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sandra L Russo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Sandra L Russo, DO
713 Dehirsch Ave,
Woodbine, NJ 08270
Ph: (609) 861-4241 | Sandra L Russo, DO
713 Dehirsch Ave,
Woodbine, NJ 08270
Ph: (609) 861-4241 |
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