Provider Demographics
NPI:1386231371
Name:GRASSI, LOUIS M (RDCS,RVT)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:M
Last Name:GRASSI
Suffix:
Gender:M
Credentials:RDCS,RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MARBETH CIR
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-1729
Mailing Address - Country:US
Mailing Address - Phone:631-775-9755
Mailing Address - Fax:
Practice Address - Street 1:39 MARBETH CIR
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-1729
Practice Address - Country:US
Practice Address - Phone:631-775-9755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
115120246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography