Provider Demographics
NPI:1295979268
Name:GROSS, ORIT (MPT)
Entity type:Individual
Prefix:MRS
First Name:ORIT
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 OCEAN AVE APT 1J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5428
Mailing Address - Country:US
Mailing Address - Phone:917-676-6766
Mailing Address - Fax:
Practice Address - Street 1:1685 OCEAN AVE APT 1J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5428
Practice Address - Country:US
Practice Address - Phone:917-676-6766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029032-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics