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Individual

DR. WENDY LYNN GROSSMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
905 BROAD ST, BLOOMFIELD, NJ 07003-2869
(973) 566-0811
(973) 566-0833
Mailing address
905 BROAD ST, BLOOMFIELD, NJ 07003-2869
(973) 566-0811
(973) 566-0833

Taxonomy

Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
Primary
25MD00230300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6641601
NJ
Enumeration date
11/28/2006
Last updated
09/14/2012
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