Provider Demographics
NPI:1316049570
Name:ROSSE, RICHARD BARNETT (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:BARNETT
Last Name:ROSSE
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 1:3402 SIESTA DRIVE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3915
Mailing Address - Country:US
Mailing Address - Phone:703-507-1524
Mailing Address - Fax:703-532-6475
Practice Address - Street 1:3402 SIESTA DRIVE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3915
Practice Address - Country:US
Practice Address - Phone:703-507-1524
Practice Address - Fax:703-532-6475
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010372402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry