Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 000075 | CT |
N | 222Z00000X | Podiatrist | 000075 | CT |
N | 213EP1101X | Primary Podiatric Medicine | 000075 | CT |
N | 213ES0131X | Foot Surgery | 000075 | CT |
NPI | 1316057474 |
---|---|
Provider Name | Dr. Norman Gross |
First Address | Ridgefield, CT 06877 |
Second Address | Ridgefield, CT 06877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030000075CT01 | ANTHEM BC (01) | CT |
0376264003 | CIGNA (01) | |
P771299 | OXFORD (01) | |
T22246 | (02) |