Doctor Name: | DR. SANTO VINCENT GRASSO |
NPI Number: | 1487788758 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | MB68666 |
Business Practice Address: | 1027 Pompton Ave Cedar Grove, NJ - 070091155 |
Business Phone Number: | 9732391699 |
Business Fax Number: | 9732391692 |
Mailing Address: | 1027 Pompton Ave, CEDAR GROVE |
State: | NJ |
Postal Code: | 070091155 |
Phone Number: | 9732391699 |
Fax Number: | 9732391692 |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MB68666 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |