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General NPI Number Information
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NPI Number | 1366780660
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Entity Type | Organization
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Legal Business Name | ROSSINOW RADIATION SERVICES PLLC
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Dates
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Enumeration Date | 01/21/2013
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Last Update Date | 05/03/2013
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Provider Practice Location Address
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Address Line | 5150 N 16TH ST STE B232
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City | PHOENIX
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State | AZ
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Zip | 85016-3925
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Country | US
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Telephone | 602-441-0008
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Fax | 866-571-0383
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Provider Business Mailing Address
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Address Line | 5150 N 16TH ST STE B232
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City | PHOENIX
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State | AZ
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Zip | 85016-3925
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Country | US
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Telephone | 602-441-0008
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Fax | 866-571-0383
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | JILL K ROSSINOW
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Credential | MD
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Telephone | 602-441-0008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 42009
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License Number State | AZ
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