Provider Demographics
NPI:1548394612
Name:JAMES C. ROSSI D.O.P.C.
Entity Type:Organization
Organization Name:JAMES C. ROSSI D.O.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-547-2337
Mailing Address - Street 1:86 OAKTREE DR
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-1503
Mailing Address - Country:US
Mailing Address - Phone:215-547-2337
Mailing Address - Fax:215-547-3317
Practice Address - Street 1:86 OAKTREE DR
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-1503
Practice Address - Country:US
Practice Address - Phone:215-547-2337
Practice Address - Fax:215-547-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002456L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007824520001Medicaid
PA099833Medicare ID - Type Unspecified
PA0007824520001Medicaid