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MARK V RUSSO DC LLC NPI 1568714376


NPI Information

NPI: 1568714376
Provider Name: MARK V RUSSO, DC, LLC

Doing Business As: RUSSO CHIROPRACTIC AND REHAB CENTER

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
157 LAFAYETTE ST
NEWARK, NJ
ZIP 07105
Phone: (973) 344-0129
Get Directions

MARK V RUSSO, DC, LLC is a chiropractor in Newark, NJ. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. MARK V RUSSO, DC, LLC NPI is 1568714376. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Russo Chiropractic And Rehab Center.

The provider's business location address is:

157 LAFAYETTE ST
NEWARK, NJ
ZIP 07105-439
Phone: (973) 344-0129
Fax: (973) 344-0243

The provider's authorized official is Mark Vincent Russo .
The authorized official title is Owner and has the following contact phone number (973) 344-0129.

The enumeration date for this NPI number is 10/4/2012 and was last updated on 10/4/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractor38MCOO235500NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1T45295MEDICARE UPINNEW JERSEY

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: 4/28/2024

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