IndividualActive
Aidan Russo, PHYSICIAN ASSISTANT
NPI 1689259772 · Medical Physician Assistant · Livingston, NJ
Provider details
- NPI number
- 1689259772
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PHYSICIAN ASSISTANT
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
15 Longview Rd
Livingston, NJ 07039-3621
Phone: (973) 650-1063
Approximate (ZIP-level) locationGet directions
Mailing address
15 Longview Rd
Livingston, NJ 07039-3621
Registry dates
- Enumerated
- 2021-03-10
- Last updated
- 2021-03-10
- Certified
- 2021-03-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.