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Individual

DR. RONALD LEE GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3765 RIVERDALE AVE, SUITE 5, BRONX, NY 10463-1845
(718) 601-2700
(718) 601-6102
Mailing address
3765 RIVERDALE AVE, SUITE 5, BRONX, NY 10463-1845
(718) 601-2700
(718) 601-6102

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
196995
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01634197
NY
01
05926H
GHI MEDICARE
NY
01
1043328289
NPI
NY
01
110223109
RAILROAD MEDICARE
NY
01
8C858
EMPIRE BLUE CROSS BLUE SH
NY
Enumeration date
08/28/2006
Last updated
01/05/2010
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