Provider Demographics
NPI:1548262272
Name:ROSSY, WILLIAM H (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:ROSSY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 MIDDLESEX AVE
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1829
Mailing Address - Country:US
Mailing Address - Phone:732-549-9363
Mailing Address - Fax:732-603-0397
Practice Address - Street 1:561 MIDDLESEX AVE
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1829
Practice Address - Country:US
Practice Address - Phone:732-549-9363
Practice Address - Fax:732-603-0397
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA03665700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4011708Medicaid
NJ875774Medicare PIN
NJ4011708Medicaid