Individual
DR. SUSANNE NG GRASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5544 GREENWICH RD STE 200, VIRGINIA BEACH, VA 23462-6563
(757) 466-0089
(757) 466-8017
Mailing address
5544 GREENWICH RD STE 200, VIRGINIA BEACH, VA 23462-6563
(757) 466-0089
(757) 466-8017
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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