Provider Demographics
NPI:1053713925
Name:ROSSIEN, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:ROSSIEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9276 JAMISON AVE
Mailing Address - Street 2:UINT A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-4281
Mailing Address - Country:US
Mailing Address - Phone:215-460-7475
Mailing Address - Fax:
Practice Address - Street 1:9276 JAMISON AVE
Practice Address - Street 2:UINT A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-4281
Practice Address - Country:US
Practice Address - Phone:215-460-7475
Practice Address - Fax:215-677-2073
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other