Michael C Russonella Orthopedic Surgeon PC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

MICHAEL C RUSSONELLA ORTHOPEDIC SURGEON PC

Practice address

14 N Main St Ste 1
Spring Valley, NY 10977-4942

Phone

(973) 340-1940

NPI assigned

Jan 5, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Russonella, DO

Title

Owner

Phone

(973) 340-1940

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1457012114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 N MAIN ST STE 1",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109774942",
            "telephone_number": "973-340-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 N MAIN ST STE 1",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109774942",
            "telephone_number": "973-340-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL C RUSSONELLA ORTHOPEDIC SURGEON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "RUSSONELLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-340-1940",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Spring Valley, NY
• Providers in Spring Valley, NY by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.