Provider Demographics
NPI:1790134898
Name:GROSSMAN, ALLISON NICOLE (MD/MPH)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:NICOLE
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:MD/MPH
Other - Prefix:
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Mailing Address - Street 1:2248 BROADWAY # 1052
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5805
Mailing Address - Country:US
Mailing Address - Phone:646-450-6254
Mailing Address - Fax:646-357-8442
Practice Address - Street 1:171 W 79TH ST STE 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6449
Practice Address - Country:US
Practice Address - Phone:646-450-6254
Practice Address - Fax:646-357-8442
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2907572084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry