MEDICARE: VICTOR J ROSSI D.C.

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
1	111N00000X	Chiropractor	MC03935	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0500652000	OTHER	NJ	AMERIHEALTH
2	P815421	OTHER	NJ	OXFORD
3	665802	OTHER	NJ	UNITED HEALTH CARE
4	4408283	OTHER	NJ	AETNA
5	0937321	OTHER	NJ	CIGNA

General Provider Information

NPI Number	:	1073506127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR J ROSSI D.C.

Provider Business Mailing Address
First Line	:	107 SHIPMASTER DR
Second Line	:
City	:	BRIGANTINE
State	:	NJ
Zip	:	08203-1300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 PHILADELPHIA AVE
Second Line	:
City	:	EGG HARBOR CITY
State	:	NJ
Zip	:	08215-1444
Country	:	US
Telephone Number	:	609-965-5533
Fax Number	:	609-965-8865

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/08/2007

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