Individual
DR. HARVEY ROBERT GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
370 GRAND AVE, SUITE 102, ENGLEWOOD, NJ 07631-4154
(201) 567-3370
(201) 816-1265
Mailing address
370 GRAND AVE STE 102, ENGLEWOOD, NJ 07631-4109
(201) 567-3370
(201) 816-1265
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA03205500
NY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
25MA03205500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069663L4S
PTAN
—
05
—
3021700
—
NJ
Enumeration date
06/09/2006
Last updated
06/02/2011
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