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General NPI Number Information
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NPI Number | 1992202980
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Entity Type | Individual
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Provider Name | SIERRA AUTUMN GRASSO DO
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Gender | Female
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 07/05/2025
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Provider Practice Location Address
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Address Line | 115 CASS AVE
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City | WOONSOCKET
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State | RI
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Zip | 02895-4731
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Country | US
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Telephone | 401-769-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 345 AVENUE A APT 201
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City | BAYONNE
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State | NJ
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Zip | 07002-1321
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Country | US
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Telephone | 440-225-4819
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 328059
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License Number State | NY
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