Doctor Name: | ELISSA R. GROSS |
NPI Number: | 1063741833 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D |
License Number: | 35SI00387300 |
Business Practice Address: | 300 Knickerbocker Road, Suite 3200 Cresskill, NJ - 076261346 |
Business Phone Number: | 2018719339 |
Business Fax Number: | |
Mailing Address: | 100 Union Ave, First Floor CRESSKILL |
State: | NJ |
Postal Code: | 076262141 |
Phone Number: | 2014031284 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2009 |
NPI Last Update Date: | 03/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 35SI00387300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |