DR. PIERRE RUSSO M.D. NPI 1114077054

NPI Information

  • NPI: 1114077054
  • Provider Name: DR. PIERRE RUSSO, M.D.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 3400 CIVIC CENTER BLVD
    PHILADELPHIA, PA
    ZIP 19104
  • Phone: (215) 590-2266

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NPI Details

DR. Pierre Russo, M.D. is a specialist in Philadelphia, PA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Pierre Russo, M.D. NPI is 1114077054. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3400 CIVIC CENTER BLVD
PHILADELPHIA, PA
ZIP 19104-306
Phone: (215) 590-2266
Fax: (215) 590-2171

The enumeration date for this NPI number is 1/11/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistMD031088EMARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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