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NPI Code Detail

MEDICARE: MR. MICHAEL GRASSO III MD

MEDICARE: MR. MICHAEL GRASSO III 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
1208800000XUrology Physician197903NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00024915OTHERNYMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100M061OTHERNYBLUECROSS BLUESHIELD
24286003OTHERNYAETNA
31099464OTHERNYGHI
51337141OTHERNYUNITED HEALTHCARE
6NS3689OTHERNYOXFORD
7197903OTHERNYHIP
8N79103OTHERNYHEALTHNET

General Provider Information

NPI Number : 1437184280
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL GRASSO III MD
Provider Business Mailing Address
First Line : PO BOX 2022
Second Line : CHURCH STREET STATION
City : NEW YORK
State : NY
Zip : 10113-2022
Country : US
Telephone Number : 212-434-6300
Fax Number : 212-434-6370
Provider Business Practice Location Address
First Line : 100 E 77TH ST
Second Line : 4TH FLOOR, EAST BLDG
City : NEW YORK
State : NY
Zip : 10075-1850
Country : US
Telephone Number : 212-434-6300
Fax Number : 212-434-6370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 08/26/2010

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