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Individual

JOSEPH GROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ADULT-GERI N.P

Contact information

Practice address
ELM AND CARLTON ST, BUFFALO, NY 14263-9591
(716) 845-2300
Mailing address
ELM AND CARLTON ST, BUFFALO, NY 14263-0001
(716) 845-2300

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
307270
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F307270
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04326867
NY
01
1324636
CIGNA
NY
01
4403930
MVP
NY
Enumeration date
07/16/2015
Last updated
11/11/2022
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