Provider Demographics
NPI:1639412406
Name:GROSSO, RILEY PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:PATRICIA
Last Name:GROSSO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 ALBERT SABIN WAY
Mailing Address - Street 2:MSB 1654
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0769
Mailing Address - Country:US
Mailing Address - Phone:513-558-8114
Mailing Address - Fax:513-558-5791
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:CENTER FOR EMERGENCY CARE
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-558-8114
Practice Address - Fax:513-558-5791
Is Sole Proprietor?:No
Enumeration Date:2013-03-30
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.131342207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program