Healthcare Provider Details

I. General information

NPI: 1861004368
Provider Name (Legal Business Name): GROSSMAN F & A PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MCKINLEY ST STE 15
CLOSTER NJ
07624-2726
US

IV. Provider business mailing address

10 MCKINLEY ST STE 15
CLOSTER NJ
07624-2726
US

V. Phone/Fax

Practice location:
  • Phone: 201-979-3050
  • Fax: 469-259-7524
Mailing address:
  • Phone: 201-979-3050
  • Fax: 469-259-7524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. LAUREN GROSSMAN
Title or Position: PRESIDENT
Credential: DPM
Phone: 201-979-3050