MEDICARE: PERI GROSS

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
1	101YM0800X	Mental Health Counselor	P10171	NY

General Provider Information

NPI Number	:	1992295067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PERI GROSS

Provider Business Mailing Address
First Line	:	361 ARGYLE RD
Second Line	:
City	:	CEDARHURST
State	:	NY
Zip	:	11516-1104
Country	:	US
Telephone Number	:	516-418-2570
Fax Number	:

Provider Business Practice Location Address
First Line	:	361 ARGYLE RD
Second Line	:
City	:	CEDARHURST
State	:	NY
Zip	:	11516-1104
Country	:	US
Telephone Number	:	516-418-2570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2018
Last Update Date	:	03/25/2026

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Directions to “ PERI GROSS ” Practice Location

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