Individual
BRADLEY P GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3600 ROUTE 112, CORAM, NY 11727-4116
(631) 920-8500
Mailing address
3600 ROUTE 112, CORAM, NY 11727-4116
(631) 920-8500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/22/2021
Last updated
12/22/2021
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