Organization
MARK GRUSSO, DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK T GRUSSO DPM (PRESIDENT)
(908) 213-0029
Entity
Organization
Contact information
Practice address
409 COVENTRY DR, PHILLIPSBURG, NJ 08865-1969
(908) 213-0029
(908) 213-9393
Mailing address
409 COVENTRY DR, PHILLIPSBURG, NJ 08865-1969
(908) 213-0029
(908) 213-9393
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4568605
—
NJ
01
—
DA8539
RAILROAD MEDICARE
NJ
Enumeration date
06/15/2006
Last updated
03/11/2008
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