Individual
JESSE GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10470 QUEENS BLVD STE 200, FOREST HILLS, NY 11375-3694
(718) 275-6010
Mailing address
301 W 110TH ST APT 6L, NEW YORK, NY 10026-4061
(917) 734-0434
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/19/2019
Last updated
12/19/2019
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