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General NPI Number Information
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NPI Number | 1659556223
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Entity Type | Individual
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Provider Name | JOHN PHILLIP ROSS D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 13102 LIBERTY AVE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-3124
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Country | US
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Telephone | 516-444-7198
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Fax | 171-832-2569
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Provider Business Mailing Address
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Address Line | 9 HAMILTON AVE
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City | ISLAND PARK
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State | NY
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Zip | 11558-1605
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Country | US
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Telephone | 516-444-7198
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Fax | 171-832-2469
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010025
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038011331
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License Number State | IL
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