Provider Demographics
NPI:1780010173
Name:GROSS, CHANA (DPT)
Entity Type:Individual
Prefix:
First Name:CHANA
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 INDIAN CREEK DR APT 505
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3258
Mailing Address - Country:US
Mailing Address - Phone:718-612-2629
Mailing Address - Fax:
Practice Address - Street 1:4101 INDIAN CREEK DR APT 505
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3258
Practice Address - Country:US
Practice Address - Phone:718-612-2629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036504225100000X
FL32906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist