Individual
MICHAEL B. GROSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
241 E MAIN ST, HUNTINGTON, NY 11743-2924
(631) 367-5300
(631) 351-4561
Mailing address
241 E MAIN ST, HUNTINGTON, NY 11743-2924
(631) 367-5300
(631) 351-4561
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
151788-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00966312
—
NY
Enumeration date
08/08/2006
Last updated
07/08/2007
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