Provider Demographics
NPI:1578678876
Name:GRASSO, ARMAND J (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMAND
Middle Name:J
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 1:727 WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1234
Mailing Address - Country:US
Mailing Address - Phone:201-251-9576
Mailing Address - Fax:201-991-0027
Practice Address - Street 1:44 RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6350
Practice Address - Country:US
Practice Address - Phone:201-991-2880
Practice Address - Fax:201-991-0027
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04695500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE13125Medicare UPIN
NJ092266Medicare ID - Type UnspecifiedPROVIDER #