Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 196057 | NY |
NPI | 1598845059 |
---|---|
Provider Name | Susan J Gross |
First Address | Bronx, NY 10471-3206 |
Second Address | Bronx, NY 10461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |