Dr. John L Roussalis
Plastic and Reconstructive Surgery
537 Stanton Christiana Rd
Newark
, Delaware 19713-2146
Dr. John L Roussalis
Plastic and Reconstructive Surgery
537 Stanton Christiana Rd
Newark
, Delaware 19713-2146
(302) 633-7556
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About
Features
Specialties
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- Dr. John L Roussalis
- 537 Stanton Christiana Rd
- Newark, DE
- Zip : 19713-2146
- Fax : (302) 633-7556
- Phone : (302) 633-7550
Second Address
- Dr. John L Roussalis
- 537 Stanton Christiana Rd
- Newark, DE
- Zip : 19713-2146
- Fax : (302) 633-7556
- Phone : (302) 633-7550
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0122X | Plastic and Reconstructive Surgery | MD426938 | PA |
National Provider Identifier
| NPI | 1235252669 |
|---|---|
| Provider Name | Dr. John L Roussalis |
| First Address | Newark, DE 19713-2146 |
| Second Address | Newark, DE 19713-2146 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/04/2007 |
| Last Update Date | 23/06/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 127068100 | (05) | WY |
| W21591 | PTAN (01) | WY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.