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NPI Code Detail

MEDICARE: ROSSI PSYCHOLOGICAL GROUP, P.A.

MEDICARE: ROSSI PSYCHOLOGICAL GROUP, P.A.
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
1103TC0700XClinical Psychologist35SI00117000NJ

General Provider Information

NPI Number : 1285808774
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROSSI PSYCHOLOGICAL GROUP, P.A.
Provider Business Mailing Address
First Line : 62 E MAIN ST
Second Line :
City : SOMERVILLE
State : NJ
Zip : 08876-2312
Country : US
Telephone Number : 908-725-8880
Fax Number : 908-725-5656
Provider Business Practice Location Address
First Line : 62 E MAIN ST
Second Line :
City : SOMERVILLE
State : NJ
Zip : 08876-2312
Country : US
Telephone Number : 908-725-8880
Fax Number : 908-725-5656
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. MARGUERITE TIGER
Credential :
Telephone Number : 908-725-8880
Provider Enumeration Date : 04/16/2008
Last Update Date : 04/16/2008

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