| Russomanno Health Center | |
|
350 Bloomfield Ave Bloomfield NJ 07003 | |
| (201) 263-1047 | |
| Not Available |
| Full Name | Russomanno Health Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 350 Bloomfield Ave, Bloomfield, New Jersey |
| Authorized Official Name and Position | Colleen Dougherty (BILLING) |
| Authorized Official Contact | 2012631047 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russomanno Health Center 350 Bloomfield Ave Bloomfield NJ 07003 Ph: (201) 263-1047 | Russomanno Health Center 350 Bloomfield Ave Bloomfield NJ 07003 Ph: (201) 263-1047 |
| NPI Number | 1275560195 |
|---|---|
| Provider Enumeration Date | 06/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275560195 | NPI | - | NPPES |
| 1258508 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA02891700 (New Jersey) | Primary |
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