Provider Demographics
NPI:1033186887
Name:GROSS, GRETTA A (DO)
Entity Type:Individual
Prefix:DR
First Name:GRETTA
Middle Name:A
Last Name:GROSS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-2521
Mailing Address - Fax:717-851-3535
Practice Address - Street 1:2003 SPRINGWOOD RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4836
Practice Address - Country:US
Practice Address - Phone:717-851-2521
Practice Address - Fax:717-260-3330
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA069602207Q00000X
PAOS010729L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA180709LMedicaid
PA001807091Medicaid
GA003134128BMedicaid
PA039663EZ3Medicare PIN
PA039663Medicare PIN
H20455Medicare UPIN