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General NPI Number Information
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NPI Number | 1215286000
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Entity Type | Organization
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Legal Business Name | AARON GROTAS MD PLLC
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 1800 ROCKAWAY AVE SUITE 212
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City | HEWLETT
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State | NY
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Zip | 11557
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Country | US
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Telephone | 516-593-1838
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Fax | 516-593-3071
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Provider Business Mailing Address
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Address Line | 1800 ROCKAWAY AVE SUITE 212
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City | HEWLETT
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State | NY
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Zip | 11557
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Country | US
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Telephone | 516-593-1838
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Fax | 516-593-3071
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Authorized Official
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Title or Position | PRESIDENT
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Name | AARON B GROTAS
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Credential | MD
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Telephone | 516-593-1838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 235473
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License Number State | NY
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