Provider Demographics
NPI:1437110228
Name:GROSS, RICHARD E (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:GROSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 POST AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-3047
Mailing Address - Country:US
Mailing Address - Phone:516-997-4466
Mailing Address - Fax:516-997-4467
Practice Address - Street 1:247 POST AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-3047
Practice Address - Country:US
Practice Address - Phone:516-997-4466
Practice Address - Fax:516-997-4467
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007621-2111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP805373OtherOXFORD
NY606270OtherACN
NY1773167OtherCIGNA
NY831314OtherMPN
NY5803775OtherGHI
NYC07621-8BOtherWC
NYX08302OtherBCBS
NYX7J561Medicare ID - Type Unspecified
NYX08302OtherBCBS