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NPI Code Detail

MEDICARE: DR. ALESSIO RUSSOMANNO DO

MEDICARE: DR. ALESSIO RUSSOMANNO DO
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
1390200000XStudent in an Organized Health Care Education/Training ProgramPA

General Provider Information

NPI Number : 1407789878
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALESSIO RUSSOMANNO DO
Provider Business Mailing Address
First Line : 1500 LANSDOWNE AVE
Second Line :
City : DARBY
State : PA
Zip : 19023-1200
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 LANSDOWNE AVE
Second Line :
City : DARBY
State : PA
Zip : 19023-1200
Country : US
Telephone Number : 610-237-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2026
Last Update Date : 06/05/2026

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Directions to “ DR. ALESSIO RUSSOMANNO DO” Practice Location

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