Provider Demographics
NPI:1114146982
Name:EDWARD A ROSBOSCHIL
Entity Type:Organization
Organization Name:EDWARD A ROSBOSCHIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PODIATRIC MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSBOSCHIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-657-2280
Mailing Address - Street 1:845 SIR THOMAS CT
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4840
Mailing Address - Country:US
Mailing Address - Phone:717-657-2280
Mailing Address - Fax:
Practice Address - Street 1:845 SIR THOMAS CT
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4840
Practice Address - Country:US
Practice Address - Phone:717-657-2280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASCOO1776L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29412Medicare UPIN
PA131085Medicare ID - Type Unspecified