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Individual

IAN GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
20 YORK ST, YNHH (CHILDREN'S) WEST PAVILION - 2ND FLOOR, NEW HAVEN, CT 06504-8900
(203) 688-2320
(203) 688-5426
Mailing address
PO BOX 9805, 300 GEORGE ST 6TH FLOOR, NEW HAVEN, CT 06536-0805

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
016410
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001164102
CT
Enumeration date
11/22/2005
Last updated
07/07/2008
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