Provider Demographics
NPI:1073506127
Name:ROSSI, VICTOR J (DC)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:J
Last Name:ROSSI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SHIPMASTER DR
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-1300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08215-1444
Practice Address - Country:US
Practice Address - Phone:609-965-5533
Practice Address - Fax:609-965-8865
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0500652000OtherAMERIHEALTH
NJP815421OtherOXFORD
NJ665802OtherUNITED HEALTH CARE
NJ4408283OtherAETNA
NJ0937321OtherCIGNA
NJ0937321OtherCIGNA
NJ4408283OtherAETNA