Provider Demographics
NPI:1134396351
Name:GROSSMAN, CRAIG ELI (MD, PHD, MSCE)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ELI
Last Name:GROSSMAN
Suffix:
Gender:M
Credentials:MD, PHD, MSCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:FARRELL
Mailing Address - State:PA
Mailing Address - Zip Code:16121-1357
Mailing Address - Country:US
Mailing Address - Phone:724-983-7570
Mailing Address - Fax:724-983-7562
Practice Address - Street 1:2200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1357
Practice Address - Country:US
Practice Address - Phone:724-983-7570
Practice Address - Fax:724-983-7562
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.00188202085R0001X
FLME1642272085R0001X
TXV97732085R0001X
IL036.1759742085R0001X
NJ25MA106742002085R0001X
AZ77862085R0001X
NH353172085R0001X
OH35C.0028602085R0001X
NY2836352085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology