Provider Demographics
NPI:1467559807
Name:ROHRS, FREDERICK BRUCE (PHD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:BRUCE
Last Name:ROHRS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:F BRUCE
Other - Middle Name:
Other - Last Name:ROHRS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:12311 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8344
Mailing Address - Country:US
Mailing Address - Phone:878-332-4240
Mailing Address - Fax:878-332-4481
Practice Address - Street 1:12311 PERRY HWY
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8344
Practice Address - Country:US
Practice Address - Phone:878-332-4240
Practice Address - Fax:878-332-4481
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006026-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103244316Medicaid
022937Medicare PIN