Provider Demographics
NPI:1851374664
Name:ROSSI, ANTHONY F (DPM)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:F
Last Name:ROSSI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-704-7386
Mailing Address - Fax:724-704-7390
Practice Address - Street 1:602 ROEMER BLVD
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1902
Practice Address - Country:US
Practice Address - Phone:724-981-2246
Practice Address - Fax:724-981-0553
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC003321L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100729420Medicaid
PA100729420Medicaid
PA552800RNOMedicare ID - Type Unspecified
PAT80567Medicare UPIN