1548258171 NPI number — MR. EMIL J ROS MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548258171 NPI number — MR. EMIL J ROS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROS
Provider First Name:
EMIL
Provider Middle Name:
J
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548258171
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 CLIFF MINE RD
Provider Second Line Business Mailing Address:
PARK WEST TWO SUITE 110
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15275-1008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-494-4550
Provider Business Mailing Address Fax Number:
412-494-4551

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 CLIFF MINE RD
Provider Second Line Business Practice Location Address:
PARK WEST TWO SUITE 110
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15275-1008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-494-4550
Provider Business Practice Location Address Fax Number:
412-494-4551
Provider Enumeration Date:
10/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  MD040052L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: MD040052L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4286763 . This is a "AETNA PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1018738120002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00761985 . This is a "MEDICARE RR INDIVIDUAL PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1327022 . This is a "KEYSTONE HEALTH PLANS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6252441 . This is a "CIGNA PROVIDER ID#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 989300 . This is a "HEALTH AMERICA/HEALTH ASSURANCE" identifier . This identifiers is of the category "OTHER".




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