Provider Demographics
NPI:1558314047
Name:COLARUSSO, FRANK JOHN (DO)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JOHN
Last Name:COLARUSSO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:JOHN MICHAEL
Other - Last Name:COLARUSSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:2501 KUSER RD STE 3
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3386
Mailing Address - Country:US
Mailing Address - Phone:609-896-0444
Mailing Address - Fax:609-896-2617
Practice Address - Street 1:2501 KUSER RD STE 3
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691
Practice Address - Country:US
Practice Address - Phone:609-896-0444
Practice Address - Fax:609-896-2617
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB080701002081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPENDINGMedicaid
NJPENDINGMedicare ID - Type Unspecified
NJPENDINGMedicaid