Provider Demographics
NPI:1114001526
Name:GROSS, BARBARA LYNN (DO)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
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 1:634 KING ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5743
Mailing Address - Country:US
Mailing Address - Phone:610-323-8866
Mailing Address - Fax:610-323-1406
Practice Address - Street 1:634 KING ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5743
Practice Address - Country:US
Practice Address - Phone:610-323-8866
Practice Address - Fax:610-323-1406
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007589L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G85372Medicare UPIN
PA022717Medicare ID - Type Unspecified