Individual
MARIO LUCIO GRASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 SPRUCE ST, 1 MALONEY BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-3793
Mailing address
31 WARD PL, SOUTH ORANGE, NJ 07079-2529
(973) 856-1934
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
251884-1
NY
207L00000X
Anesthesiology Physician
Primary
25MA08550900
NJ
207L00000X
Anesthesiology Physician
MT186316
PA
Other
Enumeration date
12/13/2006
Last updated
05/21/2009
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