MEDICARE: DR. HOWARD ROSSMAN 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
1	103T00000X	Psychologist	3733	MA
2	103TC0700X	Clinical Psychologist	3733	MA
3	103TC2200X	Clinical Child & Adolescent Psychologist	3733	MA

General Provider Information

NPI Number	:	1184647976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD ROSSMAN PH.D.

Provider Business Mailing Address
First Line	:	2 BRIGGS RD
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02421-6337
Country	:	US
Telephone Number	:	781-862-2147
Fax Number	:	781-641-5997

Provider Business Practice Location Address
First Line	:	3 WALLIS CT STE 8
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02421-5400
Country	:	US
Telephone Number	:	781-862-2147
Fax Number	:	781-641-5997

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	09/11/2025

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