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Individual

DR. JASON A GROTAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
290 CENTRAL AVE STE 207, LAWRENCE, NY 11559-8507
(516) 239-8585
(516) 239-8529
Mailing address
290 CENTRAL AVE STE 207, LAWRENCE, NY 11559-8507
(516) 239-8585
(516) 239-8529

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
NY235437
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
026631
NY
Enumeration date
09/01/2005
Last updated
12/20/2019
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