Individual
MR. NICHOLAS RICHARD GROCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
140 W 6TH ST, SUITE 210, OSWEGO, NY 13126-2525
(315) 349-5828
(315) 349-5829
Mailing address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 349-5511
(315) 349-5921
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
34-008803
OH
207Y00000X
Otolaryngology Physician
34.008803
OH
207YS0123X
Facial Plastic Surgery Physician
OS10415
FL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
270541
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000486232
ANTHEM
OH
01
—
06184
PARAMOUNT
OH
05
—
2669189
—
OH
01
—
7268808
AETNA
OH
01
—
P00358244
RRMC
OH
Enumeration date
07/09/2006
Last updated
03/29/2023
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