Healthcare Provider Details

I. General information

NPI: 1720919228
Provider Name (Legal Business Name): MAINLINE PRACTICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 SLATE HILL RD
YARDLEY PA
19067-1856
US

IV. Provider business mailing address

867 SLATE HILL RD
YARDLEY PA
19067-1856
US

V. Phone/Fax

Practice location:
  • Phone: 267-331-4823
  • Fax: 267-820-6005
Mailing address:
  • Phone: 267-331-4823
  • Fax: 267-820-6005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: BARBARA GUBBINS ROSSI
Title or Position: COO
Credential:
Phone: 267-994-7561