Healthcare Provider Details

I. General information

NPI: 1053343327
Provider Name (Legal Business Name): JEFFREY K GROSS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PLAINSBORO RD SUITE 500
PLAINSBORO NJ
08536-1915
US

IV. Provider business mailing address

5 PLAINSBORO RD SUITE 500
PLAINSBORO NJ
08536-1915
US

V. Phone/Fax

Practice location:
  • Phone: 609-936-0700
  • Fax: 609-936-0750
Mailing address:
  • Phone: 609-936-0700
  • Fax: 609-936-0750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number47820
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: