Provider Demographics
NPI:1417072703
Name:PAULA L. GROSSMAN, M.D., P.C.
Entity Type:Organization
Organization Name:PAULA L. GROSSMAN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GROSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-827-4037
Mailing Address - Street 1:4 KENT PL
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2702
Mailing Address - Country:US
Mailing Address - Phone:516-827-4037
Mailing Address - Fax:
Practice Address - Street 1:4 KENT PL
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-2702
Practice Address - Country:US
Practice Address - Phone:516-827-4037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1319392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY45A591Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NYC10070Medicare UPIN