Provider Demographics
NPI:1710079546
Name:GROSS, CATHIE CEE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHIE
Middle Name:CEE
Last Name:GROSS
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 1:101 S BERGEN PL
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3528
Mailing Address - Country:US
Mailing Address - Phone:516-415-7344
Mailing Address - Fax:516-415-7345
Practice Address - Street 1:101 S BERGEN PL
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3528
Practice Address - Country:US
Practice Address - Phone:516-415-7344
Practice Address - Fax:516-415-7345
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149368208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY907048Medicaid
NYC11371Medicare UPIN