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NPI Code Detail

MEDICARE: DR. JULIE S ROSS PH.D.

MEDICARE: DR. JULIE S ROSS PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist4503MA

General Provider Information

NPI Number : 1033129580
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIE S ROSS PH.D.
Provider Business Mailing Address
First Line : 26 STEVENS TER
Second Line :
City : ARLINGTON
State : MA
Zip : 02476-7720
Country : US
Telephone Number : 781-643-1020
Fax Number :
Provider Business Practice Location Address
First Line : 2557 MASSACHUSETTS AVE
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02140-1020
Country : US
Telephone Number : 781-643-1020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 07/08/2007

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