Healthcare Provider Details

I. General information

NPI: 1467261503
Provider Name (Legal Business Name): CAROLINE ROSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 VICTORIA ST # VB360A
PITTSBURGH PA
15213-2543
US

IV. Provider business mailing address

3234 LIBERTY AVE APT 532
PITTSBURGH PA
15201-1474
US

V. Phone/Fax

Practice location:
  • Phone: 888-747-0794
  • Fax:
Mailing address:
  • Phone: 973-906-0907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN762300
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: