Griesback, Russell

Griesback, Russell is an individual health care provider with primary practice located at 42 E Laurel Rd Udp 3100, Stratford NJ 08084-1354. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Griesback, Russell can be contacted via phone (856) 566-6859.

Contact Information

Primary practice address
42 E Laurel Rd Udp 3100 Stratford NJ 08084-1354
Phone: (856) 566-6859
Fax: (856) 566-6952
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X MB02248100 New Jersey
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MB02248100 New Jersey

Profile Details

NPI number 1598745085
LBN Legal business name Griesback, Russell
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Apr 27th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598745085 NPPES
New Jersey MEDICAID 1853503

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