MEDICARE: HAROLD S. ROSS, M.D., P.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	332H00000X	Eyewear Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	017811937	OTHER	BCBS
2	017811937	OTHER	EXCELLUS
3	9748670	OTHER	GROUP HEALTH INC
4	103065CT	OTHER	PREFERRED CARE

General Provider Information

NPI Number	:	1871552521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAROLD S. ROSS, M.D., P.C.

Provider Business Mailing Address
First Line	:	738 PRE EMPTION RD
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456-1336
Country	:	US
Telephone Number	:	315-789-8897
Fax Number	:	315-781-6342

Provider Business Practice Location Address
First Line	:	738 PRE EMPTION RD
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456-1336
Country	:	US
Telephone Number	:	315-789-8897
Fax Number	:	315-781-6342

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HAROLD S ROSS
Credential	:	MD
Telephone Number	:	315-789-4922

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	06/17/2008

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