Provider Demographics
NPI:1720155211
Name:RICHARD S. ROSS, M.D. P.A.
Entity type:Organization
Organization Name:RICHARD S. ROSS, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-589-4545
Mailing Address - Street 1:445 HURFFVILLE CROSSKEYS RD
Mailing Address - Street 2:SUITE B-14
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2337
Mailing Address - Country:US
Mailing Address - Phone:856-589-4545
Mailing Address - Fax:856-589-6210
Practice Address - Street 1:445 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:SUITE B-14
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2337
Practice Address - Country:US
Practice Address - Phone:856-589-4545
Practice Address - Fax:856-589-6210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA43541207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty