| Doctor Name: | DAVID P RUSSO |
| NPI Number: | 1588647143 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., FACS |
| License Number: | MD043941L |
| Business Practice Address: | 217 N Main St Suite 104 Cape May Court House, NJ - 082102165 |
| Business Phone Number: | 6094631488 |
| Business Fax Number: | 6094634881 |
| Mailing Address: | Po Box 593, CAPE MAY COURT HOUSE |
| State: | NJ |
| Postal Code: | 082100593 |
| Phone Number: | 6094632755 |
| Fax Number: | 6094632757 |
| NPI Enumeration Date: | 11/28/2005 |
| NPI Last Update Date: | 01/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | MD043941L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | 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. |