Provider Demographics
NPI:1093813735
Name:ROSSI, LAWRENCE NICHOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:NICHOLAS
Last Name:ROSSI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7500
Mailing Address - Street 2:SULLIVAN WAY
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-0500
Mailing Address - Country:US
Mailing Address - Phone:609-633-1562
Mailing Address - Fax:609-633-8527
Practice Address - Street 1:101 SULLIVAN WAY
Practice Address - Street 2:TRENTON PSYCHIATRIC HOSPITAL
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628-0500
Practice Address - Country:US
Practice Address - Phone:609-633-1562
Practice Address - Fax:609-633-8527
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2011-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA079969002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DO2596Medicare UPIN