MEDICARE: LINDA ELIZABETH ROSSLEY

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	175T00000X	Peer Specialist	21577	PA

General Provider Information

NPI Number	:	1467242230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA ELIZABETH ROSSLEY

Provider Business Mailing Address
First Line	:	520 RIDLEY AVE
Second Line	:
City	:	FOLSOM
State	:	PA
Zip	:	19033-1711
Country	:	US
Telephone Number	:	610-803-8743
Fax Number	:

Provider Business Practice Location Address
First Line	:	2317 E WESTMORELAND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-4529
Country	:	US
Telephone Number	:	610-803-8743
Fax Number	:

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

Provider Enumeration Date	:	05/07/2025
Last Update Date	:	05/09/2025

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