Provider Demographics
NPI:1801934526
Name:HAROLD S ROSS MD PC
Entity type:Organization
Organization Name:HAROLD S ROSS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-789-4922
Mailing Address - Street 1:738 PRE EMPTION RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1336
Mailing Address - Country:US
Mailing Address - Phone:315-789-4922
Mailing Address - Fax:315-789-1791
Practice Address - Street 1:738 PRE EMPTION RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1336
Practice Address - Country:US
Practice Address - Phone:315-789-4922
Practice Address - Fax:315-789-1791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127211332H00000X, 261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0802OtherEXCELLUS BC BS
7701336OtherDOCTORS HEALTH PLAN
100751CROtherPREFERRED CARE
7320096OtherAETNA
0802OtherHEALTHY NY
7701336OtherMVP SELECT CARE
000912620001OtherHEALTH NOW
NY00460022Medicaid
=========OtherSIDNEY HILLMAN
000912620001OtherHEALTH NOW
100751CROtherPREFERRED CARE
=========OtherGROUP HEALTH INCORPORATED
=========OtherPOMCO
=========OtherFIRST HEALTH
7701336OtherMVP SELECT CARE
000912620001OtherHEALTH NOW
=========OtherUNITED HEALTH CARE EMPIRE