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NPI Code Detail

MEDICARE: DR. MICHAEL JASON GRUSHKO MD

MEDICARE: DR. MICHAEL JASON GRUSHKO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician247707NY
2207RC0001XClinical Cardiac Electrophysiology Physician247707NY
3207R00000XInternal Medicine Physician247707NY

General Provider Information

NPI Number : 1922274364
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JASON GRUSHKO MD
Provider Business Mailing Address
First Line : 884 LONGACRE AVE
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11581-3510
Country : US
Telephone Number : 347-443-0974
Fax Number :
Provider Business Practice Location Address
First Line : 1400 PELHAM PKWY S
Second Line :
City : BRONX
State : NY
Zip : 10461-1197
Country : US
Telephone Number : 718-918-5735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2008
Last Update Date : 02/20/2025

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Directions to “ DR. MICHAEL JASON GRUSHKO MD” Practice Location

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