Provider Demographics
NPI:1356452353
Name:D.R. ROSSI, M.D., P.C.
Entity Type:Organization
Organization Name:D.R. ROSSI, M.D., P.C.
Other - Org Name:ELMONT OPEN MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-354-4200
Mailing Address - Street 1:545 ELMONT RD
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4002
Mailing Address - Country:US
Mailing Address - Phone:516-354-4200
Mailing Address - Fax:516-977-2874
Practice Address - Street 1:545 ELMONT RD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4002
Practice Address - Country:US
Practice Address - Phone:516-328-7200
Practice Address - Fax:516-328-7139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02604406Medicaid
NY06544Medicare ID - Type UnspecifiedGROUP NUMBER QUEENS CTY
NY02604406Medicaid