Provider Demographics
NPI:1073748901
Name:ARMAND J GRASSO, MD PA
Entity Type:Organization
Organization Name:ARMAND J GRASSO, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMAND
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRASSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-991-2880
Mailing Address - Street 1:44 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-6350
Mailing Address - Country:US
Mailing Address - Phone:201-991-2880
Mailing Address - Fax:201-991-0027
Practice Address - Street 1:44 RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6350
Practice Address - Country:US
Practice Address - Phone:201-991-2880
Practice Address - Fax:201-991-0027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04695500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092266Medicare PIN