Individual
EDWARD GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5624
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01272224
—
NY
01
—
P853351
OXFORD HEALTH PLANS
—
Enumeration date
01/02/2007
Last updated
06/03/2011
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