Grossman, Jonathan

Grossman, Jonathan is an individual health care provider with primary practice located at 1855 Union Blvd , Bay Shore NY 11706-7949. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Grossman, Jonathan can be contacted via phone (631) 580-9364.

Contact Information

Primary practice address
1855 Union Blvd Bay Shore NY 11706-7949
Phone: (631) 580-9364
Fax: (631) 580-9365
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R043922-1 New York

Profile Details

NPI number 1578528667
LBN Legal business name Grossman, Jonathan
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Apr 3rd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578528667 NPPES
New York MEDICAID 02246913

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