Provider Demographics
NPI:1265441794
Name:ROSSI, BROOKE VALA (MD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:VALA
Last Name:ROSSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:216-285-5028
Mailing Address - Fax:216-201-5385
Practice Address - Street 1:1000 AUBURN DR # 300
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4317
Practice Address - Country:US
Practice Address - Phone:216-285-5028
Practice Address - Fax:216-201-5385
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35-097493207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program