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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598745085 | NPPES |
| New Jersey | MEDICAID | 1853503 |
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