Provider Demographics
NPI:1144324856
Name:GROSSI, ROSS LEWIS (PT)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:LEWIS
Last Name:GROSSI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 MULLIN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-1802
Mailing Address - Country:US
Mailing Address - Phone:302-994-2511
Mailing Address - Fax:302-633-5387
Practice Address - Street 1:1601 KIRKWOOD HWY
Practice Address - Street 2:WILMINGTON VAMC
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4917
Practice Address - Country:US
Practice Address - Phone:302-994-2511
Practice Address - Fax:302-633-5387
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0001192225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist