Basic Information
| Provider Information | |||||||||
| NPI: | 1801876925 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSSI | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | C. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 UNIVERSITY DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | NEWTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189401873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157105522 | ||||||||
| FaxNumber: | 2157105181 | ||||||||
| Practice Location | |||||||||
| Address1: | 4595 NEW FALLS RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | LEVITTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2675873700 | ||||||||
| FaxNumber: | 2159492650 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2006 | ||||||||
| LastUpdateDate: | 08/15/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS002456L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0006181330002 | 05 | PA | MEDICAID | 621713200 | 01 | PA | DEPT OF LABOR | OTHER | 9634819 | 01 | PA | CIGNA | OTHER | 099833 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 4105465 | 01 | PA | AETNA | OTHER | P01704459 | 01 | PA | RR MEDICARE | OTHER | 0006181330001 | 05 | PA | MEDICAID | 30252978 | 01 | PA | KEYSTONE FIRST | OTHER |