Provider Demographics
NPI:1952506685
Name:GROSSINGER NEUROPAIN SPECIALISTS, PA
Entity Type:Organization
Organization Name:GROSSINGER NEUROPAIN SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:GROSSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-636-0920
Mailing Address - Street 1:4100 DAWNBROOK DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3932
Mailing Address - Country:US
Mailing Address - Phone:302-636-0920
Mailing Address - Fax:
Practice Address - Street 1:4100 DAWNBROOK DR
Practice Address - Street 2:SUITE 4
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-3932
Practice Address - Country:US
Practice Address - Phone:302-636-0920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000041520Medicaid
DEG02707Medicare PIN
DED80356Medicare PIN