Provider Demographics
NPI:1184647976
Name:ROSSMAN, HOWARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:ROSSMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-6337
Mailing Address - Country:US
Mailing Address - Phone:781-862-2147
Mailing Address - Fax:781-641-5997
Practice Address - Street 1:3 WALLIS CT STE 8
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5400
Practice Address - Country:US
Practice Address - Phone:781-862-2147
Practice Address - Fax:781-641-5997
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3733103T00000X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW03749Medicare UPIN
MARO W07645Medicare ID - Type Unspecified