Provider Demographics
NPI:1093708364
Name:ROST & ASSOCIATES
Entity Type:Organization
Organization Name:ROST & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/LIC. PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:717-843-6561
Mailing Address - Street 1:807 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3158
Mailing Address - Country:US
Mailing Address - Phone:717-843-6561
Mailing Address - Fax:717-845-6941
Practice Address - Street 1:807 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3158
Practice Address - Country:US
Practice Address - Phone:717-843-6561
Practice Address - Fax:717-845-6941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03186501OtherCAPITAL BLUE CROSS
PA108336OtherPA BLUE SHIELD
PA108336OtherPA BLUE SHIELD