Individual
ROBERT B GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
77 MASS AVE, MEDICAL E23-2S, CAMBRIDGE, MA 02139-4301
(617) 253-4351
Mailing address
PO BOX 425789, MEDICAL E23-2S, CAMBRIDGE, MA 02142-0015
(617) 253-4351
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2913
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W16397
BLUE CROSS
MA
Enumeration date
02/15/2006
Last updated
11/16/2012
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