Provider Demographics
NPI:1447415922
Name:WAYNE ROSSI, D.C.,P.C.
Entity type:Organization
Organization Name:WAYNE ROSSI, D.C.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PC
Authorized Official - Phone:845-986-2323
Mailing Address - Street 1:214 RONALD REAGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-4107
Mailing Address - Country:US
Mailing Address - Phone:845-986-2323
Mailing Address - Fax:845-987-1950
Practice Address - Street 1:214 RONALD REAGAN BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-4107
Practice Address - Country:US
Practice Address - Phone:845-986-2323
Practice Address - Fax:845-987-1950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003155-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000232Medicare PIN