NPI 1083683445

Glenn Gerard Russo, MD

Practitioner Procedural Dermatology Physician Gretna, LA

Practice location

Address: 120 Meadowcrest St Suite 160, Gretna, LA 70056-5255
Phone: (504) 391-7620
Fax: (504) 391-7624
Mailing address: 600 Olive Ave, Harvey, LA 70058-4456

Registered specialties

Procedural Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207NS0135X Licence 017336 (LA)

Other Dermatology providers in Louisiana →

Registry record

NPI: 1083683445
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Mar 2006
Record last updated: 3 Feb 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.