Provider Demographics
NPI:1467447011
Name:GROSS, DAVID ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ERIC
Last Name:GROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2333 MORRIS AVE
Mailing Address - Street 2:SUITE A-115
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5714
Mailing Address - Country:US
Mailing Address - Phone:908-686-5444
Mailing Address - Fax:908-686-3599
Practice Address - Street 1:2333 MORRIS AVE
Practice Address - Street 2:SUITE A-115
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5714
Practice Address - Country:US
Practice Address - Phone:908-686-5444
Practice Address - Fax:908-686-3599
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA055732000207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4559509Medicaid
NJ000663364Medicare ID - Type Unspecified
NJE78652Medicare UPIN