Individual
ERIC ROUSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Mailing address
1520 HAMILTON ST APT 516, PHILADELPHIA, PA 19130-4280
(631) 745-2552
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA062900
PA
Other
Enumeration date
09/28/2021
Last updated
12/21/2023
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