Individual
CLAIRE LOUISE GROSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
159 W 1ST ST, OSWEGO, NY 13126-2045
(315) 342-9575
Mailing address
219 HAYWOOD RD, SYRACUSE, NY 13219-2323
(315) 395-5642
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
401209101
NY
174400000X
Specialist
Primary
401210101
NY
174400000X
Specialist
743222131
NY
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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