Grossman, Mark Geoffery

Grossman, Mark Geoffery is an sole proprietor health care provider with primary practice located at 1300 Franklin Ave Suite Ul3A, Garden City NY 11530-1886. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Grossman, Mark Geoffery can be contacted via phone (516) 747-8900.

Contact Information

Primary practice address
1300 Franklin Ave Suite Ul3A Garden City NY 11530-1886
Fax: (516) 663-8124
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 224563 New York
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 224563 New York

Profile Details

NPI number 1063402014
LBN Legal business name Grossman, Mark Geoffery
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2005
Last updated Dec 30th, 2021 - about 3 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 1063402014 NPPES
New York MEDICAID 02359162

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