MEDICARE: CHRISTOPHER RUSSO DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	38MC00818600	NJ

General Provider Information

NPI Number	:	1235087446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER RUSSO DC

Provider Business Mailing Address
First Line	:	15 PROSPECT LN STE 1D
Second Line	:
City	:	COLONIA
State	:	NJ
Zip	:	07067-3048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 PROSPECT LN STE 1D
Second Line	:
City	:	COLONIA
State	:	NJ
Zip	:	07067-3048
Country	:	US
Telephone Number	:	732-827-0028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2026
Last Update Date	:	03/21/2026

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Directions to “ CHRISTOPHER RUSSO DC” Practice Location

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