Provider Demographics
NPI:1831440726
Name:ANTHONY G ROSSI
Entity type:Organization
Organization Name:ANTHONY G ROSSI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-239-5090
Mailing Address - Street 1:912 POMPTON AVE
Mailing Address - Street 2:SUITE A1
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1264
Mailing Address - Country:US
Mailing Address - Phone:973-239-5090
Mailing Address - Fax:973-239-3579
Practice Address - Street 1:912 POMPTON AVE
Practice Address - Street 2:SUITE A1
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1264
Practice Address - Country:US
Practice Address - Phone:973-239-5090
Practice Address - Fax:973-239-3579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03629400207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty