Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 282691 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 282691 | NY |
NPI | 1356714950 |
---|---|
Provider Name | Dr. Tracy B Grossman |
First Address | Bronx, NY 10463-2247 |
Second Address | Bronx, NY 10467-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2015 |
Last Update Date | 20/12/2021 |