Provider Demographics
NPI:1497930408
Name:GRASSO, ANTONIO MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:MICHAEL
Last Name:GRASSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WITMER RD
Mailing Address - Street 2:SUITE #220
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2251
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 WITMER RD
Practice Address - Street 2:SUITE #220
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2251
Practice Address - Country:US
Practice Address - Phone:215-442-5052
Practice Address - Fax:215-957-2875
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program