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NPI Code Detail

MEDICARE: CONNIE JEAN ROSSINI M.D.

MEDICARE: CONNIE JEAN ROSSINI M.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
12086S0120XPediatric Surgery Physician2024016779MO
22086S0120XPediatric Surgery Physician036137828IL
32086S0120XPediatric Surgery PhysicianMD471356PA
42086S0120XPediatric Surgery Physician0101282870VA

General Provider Information

NPI Number : 1467666081
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNIE JEAN ROSSINI M.D.
Provider Business Mailing Address
First Line : 1465 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1465 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-577-5629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 12/05/2025

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Directions to “ CONNIE JEAN ROSSINI M.D.” Practice Location

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