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Individual

DR. SUSANNE NG GRASSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
0101049252
VA
2085R0202X
Diagnostic Radiology Physician
Primary
0101049252
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139178
BCBS
VA
01
300131038
RR MEDICARE
VA
01
52735
OPTIMA
VA
05
7241194
VA
05
89065HK
NC
Enumeration date
12/07/2005
Last updated
02/07/2014
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