Provider Demographics
NPI:1407927221
Name:GROSZMANN, YVETTE S (MD)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:S
Last Name:GROSZMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:340 MAIN ST
Mailing Address - Street 2:STE. 670
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1604
Mailing Address - Country:US
Mailing Address - Phone:508-754-3566
Mailing Address - Fax:508-438-6368
Practice Address - Street 1:1 BROOKLINE PL
Practice Address - Street 2:SUITE 506
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7224
Practice Address - Country:US
Practice Address - Phone:617-739-0245
Practice Address - Fax:617-738-6703
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA221224207V00000X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2080061Medicaid
MAJ27511OtherBCBS
MA0032971OtherNEIGHBORHOOD HEALTH PLAN
MA1447533OtherCIGNA HEALTH CARE
MA469263OtherTUFTS HEALTH PLAN
MAAA12707OtherHARVARD PILGRIM
MAAA12707OtherHARVARD PILGRIM
MAA37231Medicare ID - Type Unspecified
MAA3723101Medicare PIN