Provider Demographics
NPI:1609877703
Name:GROSS, JEFFREY M (MD, FAAPMR)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:GROSS
Suffix:
Gender:M
Credentials:MD, FAAPMR
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Other - Credentials:
Mailing Address - Street 1:32 UNION SQ E
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3209
Mailing Address - Country:US
Mailing Address - Phone:212-529-5100
Mailing Address - Fax:212-529-6409
Practice Address - Street 1:32 UNION SQ E
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3209
Practice Address - Country:US
Practice Address - Phone:212-529-5100
Practice Address - Fax:212-529-6409
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY162734-12081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61499Medicare UPIN
NY24E451Medicare ID - Type Unspecified