Provider Demographics
NPI:1144520743
Name:GROSS, EDWARD ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ALEXANDER
Last Name:GROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:110 MILDRED PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-2228
Mailing Address - Country:US
Mailing Address - Phone:914-738-1569
Mailing Address - Fax:914-738-1569
Practice Address - Street 1:116 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1504
Practice Address - Country:US
Practice Address - Phone:914-738-0005
Practice Address - Fax:914-738-4019
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2013-02-21
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Provider Licenses
StateLicense IDTaxonomies
NY258996208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice