Individual
MARIO A GROSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
759 CHESTNUT ST, RADIOLOGY DEPARTMENT, SPRINGFIELD, MA 01107-1619
(413) 827-7426
(413) 827-7407
Mailing address
780 CHESTNUT ST, SPRINGFIELD, MA 01107-1610
(413) 827-7426
(413) 827-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
039842
CT
2085R0202X
Diagnostic Radiology Physician
Primary
211250
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110393
—
CT
05
—
0136310
—
MA
Enumeration date
07/04/2006
Last updated
07/08/2007
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