Individual
DR. RICHARD STEPHEN GRODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
(718) 818-4642
(718) 818-2755
Mailing address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
(718) 818-4642
(718) 818-2755
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
123591
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00462859
—
NY
Enumeration date
06/06/2006
Last updated
09/17/2008
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