Most Relevant Information
Provider Data
| NPI Number: | 1003024266 |
| Provider Name: | EDWINA GROSSMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 239995-1 |
Most Important Dates
| Enumeration Date: | 05/20/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
7471 BUCKEYE RD
LIVERPOOL
NY
130884111
Practice Location Phone/Fax
| Phone: | 3154533696 |
| Fax: |
Provider Mailing Location
45 POTTER RD
WEST MONROE
NY
131674136
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |