Provider Demographics
NPI:1750552303
Name:ROSS, SYDELLE ROWENA (MD)
Entity type:Individual
Prefix:
First Name:SYDELLE
Middle Name:ROWENA
Last Name:ROSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:350 ENGLE STREET
Mailing Address - Street 2:PAIN MANAGEMENT ENGLEWOOD HOSPITAL
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631
Mailing Address - Country:US
Mailing Address - Phone:201-894-3595
Mailing Address - Fax:
Practice Address - Street 1:350 ENGLE STREET
Practice Address - Street 2:PAIN MANAGEMENT ENGLEWOOD HOSPITAL
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:201-894-3595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192176207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine